QA Tester with ICD-9/ICD-10, HIPAA 5010, ACA, MITA, claim processing and healthcare/medicaid experience


QA Tester with ICD-9/ICD-10, HIPAA 5010, ACA, MITA, claim processing and healthcare/medicaid experience

Location: Columbia SC
Qty: 3
Duration: 12 Months


• Have demonstrated claim processing testing experience in the healthcare industry (preferably Medicaid)
• Strong analytical skills and experience with implementation and management of software

• Knowledge of QA and process metrics to measure and improve the quality of the processes and final product

• Excellent problem solving skills
• Self-motivated, independent, self-starter.
• Have a passion for achieving excellence in product quality and reliability

• Have experience in working with distributed team members
• Be extremely detail-oriented with respect to documentation and communication
• Strong database skills

• At least 5 years of experience working in a healthcare environment (preferably Medicaid)
• Strong regulation knowledge of both HIPAA 5010 transaction set and ICD-10 initiatives.

Bachelor’s degree in a technical, business, or related field. Years of experience can substitute for formal education.

This role will support testing for ACA initiatives, primarily but not limited to ICD-10 implementation. The team is comprised of healthcare professionals with both business and technical experience. Successful candidates must be individuals who are highly productive, very flexible, willing collaborators, need minimal supervision, and are self-motivated. Candidates who enjoy working on complex, change-oriented project with motivated team members, will find this position attractive. Fully integrated testing for ACA initiatives across the Enterprise with specific focus on ICD-10 testing for implementation. ICD-10 represents a major improvement to medical coding practices (diagnosis and procedure codes) that impact both providers and payers requiring significant changes to related health care policies, business processes and information systems. ICD-10-CM will completely replace ICD-9-CM for dates of service on or after October 1, 2014; and ICD-10-PCS will replace ICD-9-CM for dates of discharge on or after October 1, 2014.

Testing Analyst will be responsible for working with Department Medicaid stakeholders to identify and create test cases and scenarios, execute scenarios, document results and follow through on necessary retests. Testing Analyst must have strong Healthcare experience, extensive hands-on testing with all aspects of claims processing/business process and also be able to work closely with the business units and sub-teams to ensure their processes are fully tested.
Testing Analyst will be responsible for planning, development, execution and management reporting of end-to-end and External Trading Partner test scenarios for Department Medicaid business. The Tester will be functioning within a dynamic environment that will require vigilance to deadlines, traceability and teamwork.
Must possess strong technical debugging and troubleshooting skills coupled with strong analytical and communication skills. Experience collaborating with business analysts and Development engineers to design test cases and provide test data requirements that focus on business flows across integrated systems.
Having experience with JIRA or other test automation tools would be a plus. Must be an independent self-starter able to take on responsibility for analyzing test results and understanding healthcare products in order to design appropriate test cases

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