QA Healthcare Analyst -USA

RELQ TECHNOLOGIES; United States; Remote; USD 85,000 - 120,000; Part time

Job summary

Relq Technologies Llc. is seeking an experienced Healthcare QA Analyst focused on Membership and Claims processing, with hands-on testing of EDI 834 Enrollment and EDI 837 Claims.

The role involves validating health applications, enrollment workflows, and payer data validation in a remote US setting. Required: 5+ years in healthcare QA, expertise in membership & enrollment testing, EDI testing, SQL validation, and familiarity with Jira/Azure DevOps/ALM and Agile practices.

Qualifications

• 5+ years of QA experience in the Healthcare industry.
• Strong experience in Healthcare Membership and Claims testing.
• Hands-on experience with EDI 834 Enrollment and EDI 837 Claims transactions.
• Experience in testing healthcare payer applications.

Responsibilities

• Analyze requirements for healthcare membership and claims applications.
• Design, develop, and execute manual and automated test cases.
• Validate EDI 834 Enrollment and EDI 837 Claim transactions for accuracy and compliance.
• Perform end-to-end testing of enrollment, eligibility, claims intake, adjudication, and payment processes.
• Conduct integration, system, regression, and UAT testing.
• Validate data using SQL queries and backend databases.
• Identify, document, track, and retest defects through resolution.
• Collaborate with BAs, Developers, Product Owners, and stakeholders.
• Participate in Agile ceremonies and sprint planning.

Skills

Healthcare QA

Membership & Enrollment testing

EDI testing

SQL validation

Agile/Scrum

Education

Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, or related field

Tools

Jira

Azure DevOps

ALM

Postman

Selenium

Job description

• Member Enrollment & Eligibility
• Test Scenarios
• Defect Reports

Position Title: Healthcare QA Analyst (Membership & Claims)

Location: Remote (USA)

Duration: 6+Months Contract

Employment Type: Contract (W2/C2C)

Job Summary

We are seeking an experienced Healthcare QA Analyst with strong expertise in Healthcare Membership and Claims Processing and hands‑on experience with EDI transactions 834 (Enrollment) and 837 (Claims). The ideal candidate will be responsible for validating healthcare applications, membership enrollment processes, claims adjudication workflows, and EDI transaction testing. The candidate should possess strong knowledge of the US healthcare domain, including payer systems, HIPAA regulations, and healthcare data validation.

Required Skills

• 5+ years of QA experience in the Healthcare industry.
• Strong experience in Healthcare Membership and Claims testing.
• Hands‑on experience with EDI 834 Enrollment and EDI 837 Claims transactions.
• Experience in testing healthcare payer applications.

Strong Understanding Of

• Member Enrollment & Eligibility
• Claims Processing & Adjudication
• Benefits Configuration
• Provider & Member Data Validation

Knowledge of HIPAA compliance and healthcare regulations.

Experience with SQL for backend data validation.

Experience Creating And Executing

• Test Cases
• Test Plans
• Test Scenarios
• Defect Reports

Exposure to Agile/Scrum methodology.

Experience with defect tracking tools such as Jira, Azure DevOps, or ALM.

Key Responsibilities

• Analyze business and functional requirements for healthcare membership and claims applications.
• Design, develop, and execute manual and automated test cases.
• Validate EDI 834 Enrollment and EDI 837 Claim transactions for accuracy and compliance.
• Perform end-to-end testing of member enrollment, eligibility, claims intake, adjudication, and payment processes.
• Conduct integration, system, regression, and UAT testing.
• Validate healthcare data using SQL queries and backend databases.
• Identify, document, track, and retest defects through resolution.
• Collaborate with Business Analysts, Developers, Product Owners, and business stakeholders.
• Participate in Agile ceremonies including sprint planning, stand‑ups, and retrospectives.
• Ensure delivery of high-quality healthcare software solutions within established timelines.

Preferred Skills

• Experience with EDI testing tools.
• Knowledge of healthcare systems such as Facets, QNXT, HealthEdge, or similar payer platforms.
• Experience with API testing using Postman or SoapUI.
• Automation testing experience using Selenium or similar tools is a plus.
• Knowledge of healthcare enrollment platforms and claim lifecycle management.

Required Domain Experience

• US Healthcare / Payer Domain
• Membership & Enrollment
• Claims Processing
• EDI X12 Transactions (834, 837)
• HIPAA Compliance

Education

Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, or related field.

Nice-to-Have

• Experience with 835 Remittance, 270/271 Eligibility, 276/277 Claim Status transactions.
• Healthcare certifications or QA certifications.