Summary Information
Contract - IND
India
IT_IND
Contingent Labor
IND Default
Open
8/11/2026 8:45:17 AM
No
Request Information
Information Technology_IND - IND_Engineer
1
3
20
9/1/2026
3/1/2027
45.00
Adhikari, Kashmira
10898208
Rs0.00 (Sum of Expense * Quantity of Candidates)
General Information
Job Title: Senior Healthcare NASCO Claims Domain Specialist – Insurance UAT Testing
Job Location: Chennai / Hyderabad
Experience: 8-10 years in Healthcare Insurance with strong NASCO claims domain expertise in testing
Role Overview
- We are looking for a Senior Healthcare NASCO Claims Domain Specialist to lead and drive NASCO claims domain validation and testing initiatives for healthcare insurance applications. This role requires deep hands-on expertise in US healthcare claims processing, combined with the ability to mentor teams, guide testing strategy, and influence business decisions.
- The candidate will work onsite with client stakeholders, serving as a trusted advisor and primary domain authority across projects.
Key Responsibilities
- Senior NASCO Domain Leadership
- Serve as primary SME for end-to-end NASCO claims processing across professional, institutional, and pharmacy claims.
- Provide strategic direction and domain leadership for claims testing initiatives.
- Interpret and guide implementation of complex payer rules, benefit configurations, and provider contracts.
- Review and validate regulatory compliance with CMS, HIPAA, Medicare, Medicaid, and commercial plan requirements.
- Proactively identify domain risks, gaps, and improvement opportunities in claims workflows.
Testing Strategy & Governance
- Define overall NASCO claims testing strategy, scope, and coverage for releases.
- Review and approve test plans, scenarios, and test data from a domain correctness perspective.
- Ensure comprehensive validation of:
- Claims adjudication logic
- Pricing and repricing
- Accumulators (deductibles, MOOP)
- COB and subrogation
- Authorizations, edits, and exceptions
- Lead UAT planning and execution, including business readiness and sign-off.
- Own defect triage decisions, prioritization, and root-cause analysis.
Team Leadership & Mentorship
- Mentor junior and mid-level testers and analysts on healthcare claims concepts.
- Review test artefacts and guide offshore UAT teams to ensure domain accuracy.
- Promote best practices in domain-driven testing and knowledge sharing.
Required Skills & Qualifications
Mandatory Domain Expertise
- Extensive experience in US Healthcare Insurance – NASCO Claims Processing.
- Strong understanding of:
- Claims lifecycle and adjudication engines
- EDI (837, 835, 270/271)
- Coding standards: ICD-10, CPT, HCPCS, DRG
- Commercial, Medicare, and Medicaid plans
- Hands-on experience supporting core payer platforms.
Testing & Process Excellence
Strong manual testing background with senior-level oversight experience.
Expertise in
- Test strategy definition
- UAT leadership
- Defect governance
- Familiarity with Agile, Protected, or hybrid delivery models.
- Experience with test management and defect tracking tools (Jira, ALM, qTest).
Soft Skills & Leadership
- Excellent client-facing communication and presentation skills.
- Strong decision-making and negotiation abilities.
- Ability to handle ambiguity and complex business scenarios.
- Proven experience influencing stakeholders without direct authority.
Preferred Qualifications
- Prior experience with NASCO Claims testing, Facets, QNXT, Amisys, HealthEdge, or similar platforms.
- Experience leading large claims transformation or modernization programs.
- Certifications in Healthcare, Insurance, or Testing methodologies.
Why This Role Is Senior
- Owns domain decisions, not just execution
- Leads UAT NASCO claims testing and business sign-off
- Acts as trusted advisor to client stakeholders
- Mentors' teams and shapes testing strategy
Rate Details
IND_Engineer
Category 2
Level III
Rs65,000.00 - Rs125,000.00 Monthly NOOT
$0.00
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