FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Tech Stack
Tools & technologiesSQL
About the role
Key responsibilities & impact- Serve as Claims Domain test manager for MMIS health care projects
- Drive test strategy, testing processes, and domain knowledge
- Analyze business requirements and design and develop test plans
- Ensure quality processes and coordinate with customers on delivery and deployments
- Provide testing guidance throughout the entire project life cycle
- Meet customer expectations and troubleshoot application problems
- Assist customers with implementation decisions
- Work closely with clients and development teams during development stages
- Conduct demos at milestone completion and track and close demo feedback
- Collaborate with development, architecture, design, QA, business analysis, subject matter experts, and client teams
- Define GUI view and platform requirements
- Validate end-to-end flow from claim intake through payment and reporting
- Test integration points between systems
- Design test cases based on business rules, coverage policies, and system configurations
- Create test plans, test summary reports, and traceability matrices
Requirements
What you’ll need- Strong health care domain experience, especially Medicaid and Medicare
- Hands-on experience with claims processing and adjudication
- Experience with reference code/data sets required in claims adjudication
- Experience or understanding of configuring benefits or programs in claims systems across various subsystems
- Ability to run queries and perform basic system analysis and root cause analysis (RCA)
- Minimum of 10+ years of experience in health care, especially in the MMIS domain
- SQL knowledge for backend data validation
- Experience validating X12 files with EDI tools
- Understanding of interface testing, data flows, and formats
- Experience with Postman or similar interface/API testing tools
- Ability to validate test scenarios, test plans, and test data
- Ability to review requirements and documentation and create Requirements Traceability Matrices (RTMs)
- Excellent written and spoken communication skills
- Ability to assess product functionality against market trends and regulatory requirements
- Ability to communicate requirements to technical and architecture teams
- Experience with test planning and reporting
- Familiarity with test management tools such as ADO and JIRA
- Familiarity with claims systems such as CMdS, GHS, and Facets
- Knowledge of claims lifecycle, claim types, and EDI X12 formats including 837P/I/D, 835, 834, 270/271, and 276/277
Benefits
Comp & perks- Bonus or incentive eligibility based on business need
- Health insurance coverage
- Voluntary dental and vision programs
- Life and disability insurance
- Retirement savings plan
- Paid holidays
- Paid time off (PTO) or vacation and/or sick time