Lead Claims QA — Healthcare Adjudication & Automation

Xlysi LLC.; Chicago (IL); Remote; USD 120,000 - 180,000; Full time

Job summary

Xlysi LLC in Chicago area seeks a QA Lead with deep expertise in healthcare claims processing to drive QA for our claims adjudication and payment platforms. You will lead a QA team, define strategy, and push automation to ensure accurate pricing and payment per benefit plans and regulations.

The role requires oversight of 837/835 testing, COB, and regulatory requirements, plus hands-on automation and strong collaboration with developers, analysts, and operations.

Qualifications

• 8+ years in QA/testing with 3+ years leading teams.
• 4+ years testing healthcare claims systems (payer/TPA).
• Strong knowledge of claims adjudication workflows and provider reimbursement.
• Familiarity with HIPAA and X12 5010 transactions (837/835/834/278/277).

Responsibilities

• Define and drive QA strategy for full claims lifecycle.
• Lead functional, regression, integration, and end-to-end testing.
• Build and maintain automated test suites for claims scenarios.
• Mentor QA team and report QA metrics (auto-adjudication rate, accuracy).
• Coordinate UAT with claims operations and post-deployment validation.

Skills

Leadership

QA strategy

Test planning

Team mentoring

Regulatory compliance

Education

Bachelor's degree in CS/IT

ISTQB/CSTE/CPC certification

Tools

Selenium

Cucumber

Postman

Python/Java

JIRA

Azure DevOps

TestRail

Job description

Xlysi LLC in Chicago area seeks a QA Lead with deep expertise in healthcare claims processing to drive QA for our claims adjudication and payment platforms. You will lead a QA team, define strategy, and push automation to ensure accurate pricing and payment per benefit plans and regulations.

The role requires oversight of 837/835 testing, COB, and regulatory requirements, plus hands-on automation and strong collaboration with developers, analysts, and operations.