[Remote] QA Analyst – EDIFECS

Note: The job is a remote job and is open to candidates in USA. Ahura Workforce Solutions is seeking a QA Analyst to validate and quality-assure the EDI integration layer of a healthcare core administration platform. The role designs and executes tests for EDIFECS configurations and HIPAA X12 transaction flows, supports production troubleshooting, and collaborates with configuration teams and stakeholders.

Responsibilities

• Design, develop, and execute comprehensive test plans and test cases for EDIFECS trading partner configurations, transaction maps, and validation rules covering X12 transactions (270/271, 834, 835/837, 275, 276/277)
• Perform functional, regression, integration, and end-to-end testing of EDIFECS configurations and EDI transaction flows across development, UAT, and production-support environments
• Validate inbound and outbound EDI transaction processing — including segment-level and element-level compliance against HIPAA X12 implementation guides and payer companion guides
• Test and certify trading partner onboarding configurations, including acknowledgment flows (999, 997, TA1, 277CA) and connectivity validation (AS2, SFTP)
• Identify, document, and track defects using JIRA or equivalent tools; work closely with the EDIFECS development and configuration team to facilitate timely resolution
• Collaborate with the onsite lead and client stakeholders on requirements clarification and design validation
• Validate SpecBuilder specs, maps, and custom validation/business rules against defined requirements and companion guide standards
• Perform database validation across MongoDB, PostgreSQL, and Oracle to verify EDI transaction data integrity at the persistence layer
• Support production defect triage and troubleshooting — analyzing transaction failures and rejections, identifying root causes, and validating fixes
• Create and maintain QA documentation including test plans, test cases, traceability matrices, and defect reports
• Collaborate with the onsite lead, EDIFECS configuration team, and client stakeholders on requirements clarification, test scope definition, and sign-off
• Participate in configuration and code reviews from a quality and testability perspective
• Support broader platform modernization and regression testing initiatives by providing EDI/EDIFECS QA subject matter expertise

Skills

• Bachelor's degree in Computer Science, Engineering, Health Informatics, or a related field
• 8-10 years of experience in healthcare EDI/integration QA, with strong hands-on experience testing EDIFECS configurations (SpecBuilder, XEngine, Transaction/EDI Gateway)
• Strong working knowledge of core HIPAA X12 EDI transactions: 270/271, 834, 835/837, 275, and 276/277 — including segment and element-level validation
• Demonstrated ability to write detailed test plans, test cases, and traceability matrices for EDI/integration testing
• Experience validating trading partner onboarding flows, acknowledgment handling (999/997/TA1/277CA), and connectivity channels (AS2, SFTP)
• Hands-on experience with defect management and test management tools (JIRA, HP ALM, or equivalent)
• Ability to query and validate data in MongoDB, PostgreSQL, and Oracle databases to verify backend EDI transaction integrity
• Experience with API/EDI testing tools such as Postman, SoapUI, or similar for validating transaction payloads
• Strong analytical and debugging skills for diagnosing EDI transaction failures and rejections in high-volume production environments
• Good written and verbal communication skills for collaborating with onsite leads, developers, and client stakeholders
• Daily, practical use of AI coding/assistant tools to accelerate EDIFECS test case generation, test data creation, and defect analysis
• Able to critically review and validate AI-generated test cases, assertions, and configurations for correctness before execution
• Understanding of secure and compliant AI tool usage, including never entering PHI, member data, or other sensitive information into prompts or external AI tools
• Able to identify where AI-driven automation can improve day-to-day EDI testing, regression coverage, or defect triage efficiency
• Experience with health plan/payer core administration systems (e.g., Facets, QNXT, HealthRules) from a QA/testing perspective
• Familiarity with CAQH CORE operating rules and their testing implications
• Exposure to automated testing frameworks applicable to EDI/integration testing pipelines
• Experience with mainframe or cloud-based integration patterns supporting EDI processing
• Relevant certifications: EDIFECS product certifications, ISTQB, or equivalent QA certifications

Benefits

• Remote work

Company Overview

Company H1B Sponsorship