Job Title: QA/Testing Engineer (Healthcare)
Duration: 06 Months (Contract to Hire) (W2 Contract Only)
Location: Remote
Technical Must Haves
· Must have 5+ years of hands-on Healthcare QA/Testing experience with a strong focus on MMIS (Medicaid Management Information System) projects.
· Must have extensive hands-on Claims Testing experience across the complete healthcare claims lifecycle.
· Must have strong Healthcare domain knowledge with expertise in both Medicaid and Medicare.
· Must have hands-on experience with Claims Processing and Claims Adjudication.
· Must have strong understanding of claims reference codes, reference data sets, and business rules required for claims adjudication.
· Must have experience configuring benefits, programs, and claims system setup across multiple claim processing subsystems.
· Must have strong SQL skills to validate backend data, claims status, payment information, members, providers, and benefit plans.
· Must have experience performing system analysis, root cause analysis (RCA), and defect validation.
· Must have experience validating end-to-end claims processing from claim intake through adjudication, payment, and reporting.
· Must have experience testing Professional, Institutional, Dental, Pharmacy, Encounter, and Capitation claims.
· Must have experience working with EDI X12 transactions including 837P, 837I, 837D, 835, 834, 270/271, and 276/277.
· Must have experience validating EDI transactions using EDI validation tools.
· Must have experience with Interface Testing and API Testing using Postman or similar tools.
· Must have experience creating test strategies, test plans, test cases, test scenarios, test data, and test summary reports.
· Must have experience preparing and maintaining Requirements Traceability Matrix (RTM).
· Must have experience using test management tools such as Azure DevOps (ADO), JIRA, or equivalent.
· Must have experience working with claims processing platforms such as Facets, CMdS, GHS, or similar healthcare claims systems.
· Must have experience collaborating with Development, Architecture, Business Analysts, SMEs, and client teams throughout the SDLC.
· Must have experience participating in client demonstrations, validating milestones, tracking feedback, and supporting production implementations.
· Must have strong written and verbal communication skills with the ability to manage multiple priorities and work directly with clients.
Desired
· Desired experience working on large-scale Medicaid MMIS modernization or implementation projects.
· Desired experience with healthcare benefit configuration and policy validation.
· Desired experience assessing regulatory requirements and validating compliance changes within healthcare claims systems.
· Desired experience supporting GUI validation and application design reviews.
· Desired experience performing integration testing across multiple healthcare systems and interfaces.
· Desired experience creating innovative testing approaches and improving QA processes.
· Desired experience working in Agile or hybrid software development environments.
· Desired ability to provide testing guidance throughout the full software development lifecycle.
· Desired experience supporting production deployments, release validation, and post-implementation testing.
· Desired experience working closely with cross-functional business and technical stakeholders to deliver high-quality healthcare solutions.
Primus Software Corporation. Primus Software Corporation is a global staff augmentation firm providing a wide-range of talent on-demand and total workforce solutions. We have excellent domain expertise in all verticals. We provide long term solutions with quality as our main focus. To learn more about Primus Software Corporation, please visit our website www.primussoftcom. I recently came across your resume on job boards, and I wanted to reach out to you regarding an exciting job opportunity that I believe aligns perfectly with your skills and experience.