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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in end-to-end testing of healthcare claims, including validation of claim adjudication outcomes and payment calculations. Proficient in creating test plans, executing test cases, and collaborating with stakeholders to ensure compliance with business requirements.
Highest-signal resume keywords
Healthcare Claims TestingACAS Platform ValidationTest Case ExecutionRegression TestingUser Acceptance Testing (UAT)
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
End-to-End TestingClaim Adjudication ValidationPayment Calculation ValidationTest Plan PreparationDefect IdentificationTest Execution ReportingTraceability MatricesIntegration TestingSystem TestingClaims Data Review
Soft Skills
CollaborationAnalytical SkillsDocumentation
Certifications & Qualifications
Bachelor's Degree in Computer ScienceBachelor's Degree in Information TechnologyBachelor's Degree in Healthcare Management
Industry Keywords
Healthcare ClaimsPayment IntegrityOverpayment RecoveryRefund ProcessingClaims Rework WorkflowsBusiness RequirementsRelease ValidationProduction VerificationPost-Implementation TestingTest Scenarios
About the role
Key responsibilities & impact- 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
Requirements
What you’ll need- Bachelor's Degree in Computer Science, Information Technology, Healthcare Management, or related field
- Relevant experience in US Healthcare Claims Testing and ACAS platform validation