Senior Test / QA Analyst

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    "datePosted": "2026-05-27",
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    "description": "<p><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 8pt; font-weight: bold\"><span style=\"font-family: Arial, Helvetica, Verdana, sans-serif; font-size: 10pt\">This is a 4-month engagement. It's a fully remote position; candidates must be available to work Pacific Time (PST) hours. Senior Test / QA Analyst needed to support a West Coast healthcare client in a fast-paced payer environment. Seeking candidates with strong experience in health plan claims testing, including medical claims adjudication, HIPAA EDI transaction testing (837/835/270/271), SQL validation, and end-to-end QA processes. Ideal candidates will have experience working with core claims administration platforms such as FACETS, QNXT, ika, PCM, or similar systems. Strong knowledge of healthcare claims workflows, payer operations, and QA best practices is highly preferred.</span></span></p>\n<p><br><br></p>\n<p><span style=\"font-size: 10pt; font-weight: bold\"><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif\">Location:</span><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif\"> Fully Remote (Must be available to work Pacific Time hours)</span></span></p>\n<p><br></p>\n<p><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold\">Description:</span></p>\n<p><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Impresiv Health is seeking an experienced Senior Test / QA Analyst to support a West Coast healthcare client in a 4-month engagement focused on health plan claims processing systems. This role requires deep expertise in healthcare claims adjudication, EDI transaction testing, regulatory compliance, and enterprise quality assurance methodologies. The ideal candidate is highly analytical, detail-oriented, and experienced leading testing efforts across complex payer environments involving medical, pharmacy, and dental/vision claims.</span></p>\n<p><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">What You Will Do:</span></p>\n<ul>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Design, develop, and execute comprehensive test strategies, test plans, test cases, and test scripts for health plan claims processing systems.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Validate end-to-end claims adjudication workflows including intake, pricing, benefit application, coordination of benefits (COB), payment processing, and EOB generation.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Perform testing and validation of HIPAA-compliant EDI transaction sets including 837, 835, 270/271, 276/277, and 834 transactions.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Verify claims payment accuracy against fee schedules, contracted provider rates, DRG/APR-DRG methodologies, per diem structures, and MAC pricing logic.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Test auto-adjudication workflows, prior authorization integrations, manual review queues, and claims editing logic.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Lead defect management activities including defect triage, root cause analysis, regression testing, and release validation.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Partner with business analysts, claims operations teams, developers, and external trading partners to translate requirements into testable scenarios.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Produce detailed test documentation including defect reports, traceability matrices, test summaries, and QA metrics dashboards.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Support UAT coordination and release readiness activities across Agile and waterfall project environments.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Ensure compliance with ACA, CMS, NCQA, HIPAA, state DOI mandates, and other applicable healthcare regulations.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Validate code set updates including ICD-10-CM/PCS, CPT, HCPCS, NDC, and revenue code table refreshes.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Mentor junior QA analysts and contribute to QA standards, frameworks, and best practices.</span></li>\n</ul>\n<p><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">You Will Be Successful If:</span></p>\n<ul>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Possess deep functional knowledge of healthcare claims adjudication and payer operations.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Demonstrate confidence validating complex claims processing workflows and EDI transaction pipelines with high accuracy.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Thrive in fast-paced environments managing multiple testing priorities across release cycles.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Communicate effectively with both technical and operational stakeholders.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Maintain strong attention to detail while proactively identifying risks, defects, and process improvement opportunities.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Bring a solid understanding of healthcare compliance and regulatory testing requirements.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Successfully lead testing initiatives independently while collaborating cross-functionally within Agile teams.</span></li>\n</ul>\n<p><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">What You Will Bring:</span></p>\n<ul>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">5 years of QA/testing experience, including at least 3 years supporting health plan claims processing systems.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Strong experience with medical claims adjudication including COB, subrogation, remittance processing, and claims editing platforms such as ClaimLogic, ClaimsXten, or similar tools.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Hands-on experience testing HIPAA EDI transactions including 837P/837I, 835, 276/277, and 270/271 transactions.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Proficiency with SQL for test data validation and backend verification activities.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Experience with health plan core administration platforms such as TriZetto FACETS, QNXT, ika, PCM, or similar systems.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Experience working within Agile/Scrum environments utilizing Jira, Azure DevOps, Rally, or similar tools.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Strong understanding of ICD-10, CPT/HCPCS coding structures, modifier logic, and revenue codes.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Excellent analytical, troubleshooting, documentation, and communication skills.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Experience with pharmacy claims testing, Medicare Advantage claims processing, or PBM integrations is preferred.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Familiarity with test automation and API testing tools including Selenium, Postman, and SOAP UI is a plus.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">QA certifications such as ISTQB or CSTP are preferred.</span></li>\n<li><span style=\"color: rgb(25, 25, 25); font-family: Arial, sans-serif; font-size: 10pt\">Bachelor?s degree in Computer Science, Information Systems, Healthcare Administration, or related field; equivalent experience considered.</span></li>\n</ul>",
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