EDI Tester

Apex Systems; Pleasanton, Northern (CA, KY); Hybrid; USD 55,000 - 90,000; Full time

Job summary

Apex Systems is actively hiring an EDI Tester for a large Healthcare client. This fully remote role supports California EDI connections and focuses on validating 834 files for formatting and data quality.

The tester will perform membership validation, scenario testing, and defect identification, collaborating with EDI developers and QA teams to ensure enrollments are accurate and compliant.

Qualifications

• Experience with California EDI is mandatory.
• Deep knowledge of HIPAA 834 structure, loops, segments, and benefit codes is required, along with experience in membership testing, eligibility validation, and file reconciliation.

Responsibilities

• Execute membership testing for California EDI connections.
• Validate inbound and outbound 834 files for accuracy, formatting, and compliance.
• Perform scenario testing, regression testing, and enrollment lifecycle validation.
• Identify defects, missing fields, incorrect plan codes, and demographic mismatches.
• Document test results, defects, and required corrections.
• Collaborate with EDI developers, enrollment operations, and QA teams.
• Support open enrollment testing cycles and high-volume periods.

Skills

QA Testing

Analytical Skills

Documentation

Defect Tracking

HIPAA 834 Knowledge

Tools

JIRA

Job description

Apex Systems is hiring an EDI Tester for a large Healthcare client.Location: Fully remote anywhere in the United States.3 months contract with potential to extend.

Role Overview

The EDI Tester is responsible for performing detailed membership testing for a California-based enrollment ecosystem. This position focuses on validating 834 files to ensure compliance with formatting standards and identifying defects in enrollment data. This is a technical testing role.

Key Responsibilities

• Execute membership testing for California EDI connections.
• Validate inbound and outbound 834 files for accuracy, formatting, and compliance.
• Perform scenario testing, regression testing, and enrollment lifecycle validation.
• Identify defects, missing fields, incorrect plan codes, and demographic mismatches.
• Document test results, defects, and required corrections.
• Collaborate with EDI developers, enrollment operations, and QA teams.
• Support open enrollment testing cycles and high-volume periods.

Required Qualifications

• Experience: Experience with California EDI is mandatory.
• Deep knowledge of HIPAA 834 structure, loops, segments, and benefit codes is required, along with experience in membership testing, eligibility validation, and file reconciliation.

Technical Skills

The ability to work in structured testing environments such as JIRA and other QA tools is required. Strong analytical skills, attention to detail, and strong documentation and defect-tracking skills are also necessary.

About Everforth Apex

Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico.

Everforth Apex Benefits Overview

• Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection.
• We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure.
• Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
• In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA.
• You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide.

Equal Opportunity and Inclusion

Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

If you require an accommodation under the Americans with Disabilities Act to participate in an interview with a virtual recruiter or to use our website for a search or application, please contact our Benefits Department at [e-mail] or 804-523-8228. Please note that this contact information is strictly to be used for medical ADA accommodations and that no other inquiries will be answered.

UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems.