Remote Position
[Remote] Test Lead - Healthcare Payer Testing
🌍 Remote · United States
💼 Full-time
Note: The job is a remote job and is open to candidates in USA. HealthEdge is seeking a Test Lead to drive test planning and execution for healthcare payer system engagements. The role owns hands-on test case design, defect management, and daily execution quality while coordinating with the Test Manager and cross-functional delivery teams.
Responsibilities
- Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows
- Lead functional, integration, regression, and UAT cycles for assigned payer modules
- Analyze requirements and business rules — identify gaps, ambiguities, and testability issues before execution begins
- Own defect lifecycle management: logging, triage, root cause classification, retest, and closure tracking
- Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards
- Support compliance and regulatory test cycles — ICD updates, CMS mandates, state-specific Medicaid rules
- Coordinate with developers, BAs, and configuration teams to resolve blockers and clarify expected behavior
- Produce daily/weekly execution status reports with defect metrics, coverage status, and risk flags
- Manages offshore QA analysts
Skills
- We can only consider US Citizens or Green Card holders for this position at this time
- 5+ years in software QA/testing
- 2+ years in a lead or senior tester role
- Solid experience testing U.S. healthcare payer systems — claims, enrollment, benefits, or provider network
- Working knowledge of EDI X12 transactions and HIPAA compliance requirements
- Hands-on test case design experience using boundary analysis, equivalence partitioning, and negative testing techniques
- Proficiency in defect tracking and test management tools (JIRA, Zephyr, ALM, or equivalent)
- Ability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs
- Strong attention to detail — payer system defects have financial and compliance consequences
Benefits
- Remote work in the US
Company Overview