Job Summary
The Senior QA Engineer will support testing initiatives across Medicaid claims processing and healthcare applications. The role requires strong healthcare quality assurance experience, particularly in Medicaid claims processing, claims adjudication, or Pharmacy Benefit Management (PBM) systems. This is a hands-on individual contributor role focused on functional testing, backend validation, defect management, and ensuring the accuracy of complex healthcare claims workflows. The ideal candidate will understand claims processing business operations and be able to independently execute tests, troubleshoot issues, and collaborate with development and business teams.
Key Responsibilities
• Perform hands-on QA testing for Medicaid claims processing and healthcare applications.
• Develop, execute, and maintain test cases based on business and technical requirements.
• Validate end-to-end claims processing, adjudication, eligibility, and benefit configuration workflows.
• Perform functional, regression, integration, end-to-end, and backend testing.
• Use SQL queries and other tools to validate claims data and identify discrepancies.
• Investigate defects, perform root cause analysis, and collaborate with development teams to resolve issues.
• Support testing for system enhancements, configuration updates, implementations, and production releases.
• Participate in Agile ceremonies and collaborate with business analysts, developers, and other QA engineers.
• Ensure testing aligns with healthcare business requirements and applicable regulatory expectations.
• Validate healthcare claims workflows and business rules to ensure accurate application behavior.
Required Qualifications
• 5+ years of software QA/testing experience, preferably within healthcare applications.
• Strong experience with Medicaid claims processing, claims adjudication, or PBM systems.
• Experience performing functional, regression, integration, and end-to-end testing.
• Understanding of healthcare claims workflows, business rules, and configuration changes.
• Experience with backend testing, SQL queries, and data validation.
• Ability to create and execute test cases, document defects, and troubleshoot issues.
• Experience working in Agile environments and collaborating with developers, business analysts, and stakeholders.
• Strong analytical, communication, and problem-solving skills.
Preferred Qualifications
• Experience with Medicaid Managed Care, Medicare, or government healthcare programs.
• Experience with PBM platforms, pharmacy claims, eligibility, benefits, and claims adjudication.
• Experience testing claims configuration, pricing, reimbursement, or benefit changes.
• API testing experience using Postman or similar tools.
• Exposure to test automation tools or frameworks.
• Experience supporting healthcare implementations, system migrations, or production releases.
• Previous experience with client or other healthcare payer organizations.
