Senior Executive
Summary
Tests healthcare claims processing systems, validating claim adjudication, pricing logic, and payment calculations for accuracy and compliance with business requirements.
Key Responsibilities
- Perform end-to-end testing of healthcare claims processed through the ACAS platform.
- Validate claim adjudication outcomes, pricing logic, payment calculations, and benefit application.
- Execute test cases for overpayment recovery, refund processing, and claims rework workflows.
- Validate payment integrity edits and ensure accurate implementation of business requirements.
- Analyze test results, identify defects, document findings, and coordinate with development teams for resolution.
- Perform regression, integration, system, and user acceptance testing (UAT).
- Review claims data and validate member, provider, and claim attributes.
- Support release validation, production verification, and post-implementation testing activities.
- Collaborate with business stakeholders to understand requirements and create comprehensive test scenarios.
- Prepare test plans, test cases, traceability matrices, and test execution reports.
Key Responsibilities
- Perform end-to-end testing of healthcare claims processed through the ACAS platform.
- Validate claim adjudication outcomes, pricing logic, payment calculations, and benefit application.
- Execute test cases for overpayment recovery, refund processing, and claims rework workflows.
- Validate payment integrity edits and ensure accurate implementation of business requirements.
- Analyze test results, identify defects, document findings, and coordinate with development teams for resolution.
- Perform regression, integration, system, and user acceptance testing (UAT).
- Review claims data and validate member, provider, and claim attributes.
- Support release validation, production verification, and post-implementation testing activities.
- Collaborate with business stakeholders to understand requirements and create comprehensive test scenarios.
- Prepare test plans, test cases, traceability matrices, and test execution reports.
Bachelor Degree / Postgraduate Degree 3 - 7 Years