Remote QA Lead – Healthcare Encounters Data

Xlysi LLC.

Dallas (TX)

Teletrabalho

USD 140 000 - 180 000

Tempo integral

Há 3 dias

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Resumo da oferta

Xlysi LLC, Expert Portal Solutions, is seeking a QA Lead with deep expertise in healthcare encounter data to own the test strategy for our encounter processing platform, supervise a QA team, and collaborate with product, business analysts, and compliance. This remote role is W2 only.

You will define end-to-end QA strategy for encounter data lifecycle, validate 837/999 files, oversee automation, create synthetic test data, and drive defect resolution with cross-functional teams while ensuring

Qualificações

8+ years in QA/testing with 3+ years in a lead role.
4+ years with healthcare encounter data (Medicaid/Medicare or commercial).
Strong knowledge of X12 5010 transactions (837, 835, 999, 277CA).
Understanding of ICD-10-CM/PCS, CPT, HCPCS, and revenue codes.
Proficient in SQL for data validation and reconciliation.
Experience with test automation frameworks (Selenium, Cucumber, Postman, REST Assured, Python/Java).
Experience with JIRA, Azure DevOps, TestRail, Zephyr.
Strong analytical and stakeholder management.

Responsabilidades

Define and own the end-to-end QA strategy for encounter data lifecycle: intake, validation, transformation, submission, rejection handling, and resubmission.
Lead test planning, design, and execution for 837P/837I/837D encounter files and related acknowledgments (999, 277CA) and response files.
Validate encounter submissions to regulators and partners (e.g., state Medicaid agencies, CMS MAO-004/EDPS, T-MSIS).
Verify encounter-to-claim reconciliation, including paid, denied, adjusted, and voided claim scenarios, and logic for replacement and void encounters.
Design test scenarios for risk adjustment data flows, including diagnosis and provider data integrity.
Build and maintain automated regression suites for encounter validation rules, edits, and mapping logic.
Create and manage synthetic, de-identified test data sets that meet HIPAA requirements.
Analyze rejection and error reports, perform root cause analysis, and drive defect resolution with development teams.
Establish QA metrics and dashboards (defect leakage, rejection rates, test coverage, submission accuracy).
Mentor and manage QA engineers; set standards for test documentation and review.
Support UAT, regulatory audits, and production release validation.
Partner with compliance to keep testing aligned with HIPAA, CMS, and state-specific encounter requirements.