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Testing Specialist
CVS Health. Develop and execute comprehensive testing processes for system enhancements and new products and processes covering claims, enrollment, provider contracts, and benefits administration .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in developing and executing comprehensive testing processes for system enhancements and new products, with a strong focus on claims processing, benefits administration, and vendor contract audits. Proficient in validating test results and communicating outcomes effectively to stakeholders.
Highest-signal resume keywords
Testing Processes DevelopmentClaims Processing ExperienceMedical Terminology KnowledgeCommunication SkillsVendor Contract Audits
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Test Plans PreparationUnit Testing ProcessesQuality Audits ExecutionDiscrepancy DocumentationSystem Function Verification
Soft Skills
Verbal CommunicationWritten CommunicationProblem Resolution
Tools & Technologies
IDX Managed CareQNXT Managed Care
Industry Keywords
Claims AdministrationBenefits AdministrationCost ContainmentCoordination Of BenefitsDiagnosis Coding
About the role
Key responsibilities & impact- Develop and execute comprehensive testing processes for system enhancements and new products and processes covering claims, enrollment, provider contracts, and benefits administration
- Create and execute defined unit testing processes to provide quality audits for vendor contracts before implementation
- Assist with testing simple system enhancements
- Prepare and execute comprehensive test plans and test scripts to audit vendor contracts and maintain quality and accuracy
- Verify system functions according to user requirements and established guidelines
- Follow standardized best practices for documenting and executing simple to moderately complex test plans
- Validate test results, document discrepancies, and follow through with resolutions
- Report problem-resolution progress to management
- Communicate test outcomes to end users for sign-off
- Serve as liaison between system end users and the IT team
- Perform other duties as required
Requirements
What you’ll need- 2+ years related experience in a service center medical claims (not RX claims) processing or managed care operational role
- 1 year recent and related system processing, payment, and benefits experience, preferably IDX managed care
- Broad knowledge of medical terminology, claims, customary and reasonable cost containment, coordination of benefits, diagnosis coding, and general customer services sources
- Excellent verbal and written communication skills
- High School Diploma or GED
- Preferred: QNXT managed care
Benefits
Comp & perks- CVS Health bonus, commission or short-term incentive program in addition to base pay
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being, based on eligibility