The Senior Automation Test Engineer (Claims / Encounters - US Healthcare) will lead offshore quality engineering efforts for encounter processing, owning test strategy, EDI validation, and automation across payer systems. This role requires deep expertise in encounter submissions, regulatory requirements, and defect root cause analysis.
Key Responsibilities
- Own and drive end-to-end encounter testing strategy across all lines of business
- Lead the design and validation of complex encounter scenarios, including submission edits, rejection handling, and resubmissions
- Oversee 837 transaction lifecycle and ensure accurate processing through acknowledgements (277CA, 999, TA1)
- Enforce compliance with CMS guidelines and state-specific companion guides
- Lead Facets claims-to-encounter validation and reconciliation across downstream systems
- Define and drive test automation strategy using TOSCA or Robot Framework (MANDATORY) to improve regression coverage
- Conduct root cause analysis (RCA) for encounter rejections, errors, and CMS/state edit failures
- Mentor QE engineers and analysts on EDI standards, encounter validation, and automation best practices
- Collaborate with onshore teams, product owners, and stakeholders to ensure high-quality delivery
- Ensure adherence to Agile practices, ADO governance, and defect lifecycle management
Required Skills
- 8+ to 12 Years Extensive experience with Facets claims module and encounter data processing
- Deep expertise in X12 EDI transactions (837P/I/D, 277CA, 999/TA1)
- Robust automation experience with TOSCA or Robot Framework (MANDATORY)
- Advanced SQL and reconciliation expertise
- Hands-on experience with Edifecs or equivalent EDI validation tools
- Strong understanding of CMS encounter submission requirements and state companion guides
- Proven leadership, mentoring, and problem-solving capabilities
Locations: Vadodara / Pune / Bangalore / Hyderabad / Chennai Shift: 2 PM to 11 PM IST