Senior Healthcare QA Lead - Payer Claims & API Testing

Covetus; United States; On-site; USD 110,000 - 150,000; Full time

Job summary

Covetus is seeking a Lead QA Engineer with deep experience in the Healthcare Payer domain. The role focuses on testing Claims or Encounters, validating EDI transactions, and ensuring data integrity across payer platforms and APIs.

The ideal candidate will read EDI loops, work with Facets modules, and leverage tools like Postman, RestAssured, or SoapUI to drive robust test automation and defect triage in an Agile setting. Knowledge of Medicaid is highly valued.

Qualifications

• Experience in healthcare payer QA testing, including Medicaid/Medicare.
• Hands-on testing of Claims or Encounters (837 transactions) and downstream payer workflows.
• Strong understanding of X12 EDI transactions (834, 837P/I/D, 277CA, 999/TA1, 835, 278, 270/271, 820).
• Proficiency with Facets modules such as Claims, Membership/Enrollment, or Provider/Network configuration.
• Experience reading EDI loops and companion guides; Edifecs or similar tools a plus.
• APIs testing and data validation experience; SQL for cross-system validation.

Responsibilities

• Lead sprint-level QA activities in Agile environments including UAT and go-live.
• Collaborate with business stakeholders, developers, product owners, and client teams.
• Own defect management, root-cause analysis, and regression testing.
• Coordinate test planning, data validation, and traceability across payer workflows.

Skills

Test design

SQL

API testing

Python/Java

Azure DevOps

qTest

AI-assisted testing

Tools

Facets

Edifecs

Postman

RestAssured

SoapUI

Job description

Covetus is seeking a Lead QA Engineer with deep experience in the Healthcare Payer domain. The role focuses on testing Claims or Encounters, validating EDI transactions, and ensuring data integrity across payer platforms and APIs.

The ideal candidate will read EDI loops, work with Facets modules, and leverage tools like Postman, RestAssured, or SoapUI to drive robust test automation and defect triage in an Agile setting. Knowledge of Medicaid is highly valued.