Healthcare Claims Testing & QA Specialist

CVS Health; United States; Remote; USD 23,000 - 35,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits

Wellness programs

Job summary

CVS Health is seeking a QA-focused tester to develop and run comprehensive tests across claims, enrollment and benefits administration. You will create test plans, run scripts, verify results, and report issues to stakeholders.

The role acts as a bridge between end users and IT, ensuring quality before deployment and sign-off. Ideal candidates bring at least 2+ years in medical claims processing, plus familiarity with healthcare systems and clear written/verbal communication.

Qualifications

• 2+ years in a service center medical claims processing or managed care operational role.
• 1 year recent system processing, payment, and benefits experience.
• Broad knowledge of medical terminology, claims, cost containment, COB, diagnosis coding, and customer service.

Responsibilities

• Develops and executes testing processes for system enhancements and new products across customer service.
• Creates and executes test plans and scripts to audit vendor contracts prior to implementation.
• Verifies system functions align with user requirements and documents discrepancies.
• Acts as liaison between end users and IT; communicates results for sign-off; follows up on resolutions.

Skills

Communication skills

Claims processing

Medical terminology

Quality assurance

Education

High School Diploma or GED

Tools

IDX system

Job description

CVS Health is seeking a QA-focused tester to develop and run comprehensive tests across claims, enrollment and benefits administration. You will create test plans, run scripts, verify results, and report issues to stakeholders.

The role acts as a bridge between end users and IT, ensuring quality before deployment and sign-off. Ideal candidates bring at least 2+ years in medical claims processing, plus familiarity with healthcare systems and clear written/verbal communication.