QA Engineer

JD #4: SDET Engineer

• Provider data management Job Description : Healthcare Domain
• Provider data management — directory accuracy, credentialing, prior authorization (278), eligibility (270/271), 835 payment linkage across Medicaid/MA/Duals/TRICARE/Marketplace Core Skills Needed
• Facets (REQUIRED), X12 EDI (278, 270/271, 835), provider data (NPI/TIN/taxonomy), SQL, TOSCA, ADO Core technical & domain requirements: Facets Facets — REQUIRED: provider, contract, and network module testing and configuration validation in Facets X12 EDI: 278 (Prior Authorization request & response), 270/271 (Eligibility & Benefit inquiry/response) Provider demographic data validation — NPI, TIN, taxonomy codes, specialty, address, network status Provider enrollment & credentialing workflow testing (add, update, term, reactivation) 835 remittance linkage to provider payment validation Provider directory accuracy testing — plan-level, network-tier, accepting-new-patients flags SQL for provider data cross-validation (provider master ↔ claims ↔ eligibility ↔ directory) TOSCA or similar automation tools LOB coverage: Medicaid, Medicare Advantage, Duals/MMP, TRICARE, Marketplace JD #4: SDET Engineer
• Provider data management Job Description: Healthcare Domain
• Provider data management — directory accuracy, credentialing, prior authorization (278), eligibility (270/271), 835 payment linkage across Medicaid/MA/Duals/TRICARE/Marketplace Core Skills Needed
• Facets (REQUIRED), X12 EDI (278, 270/271, 835), provider data (NPI/TIN/taxonomy), SQL, TOSCA, ADO Core technical & domain requirements: Facets Facets — REQUIRED: provider, contract, and network module testing and configuration validation in Facets X12 EDI: 278 (Prior Authorization request & response), 270/271 (Eligibility & Benefit inquiry/response) Provider demographic data validation — NPI, TIN, taxonomy codes, specialty, address, network status Provider enrollment & credentialing workflow testing (add, update, term, reactivation) 835 remittance linkage to provider payment validation Provider directory accuracy testing — plan-level, network-tier, accepting-new-patients flags SQL for provider data cross-validation (provider master ↔ claims ↔ eligibility ↔ directory) TOSCA or similar automation tools LOB coverage: Medicaid, Medicare Advantage, Duals/MMP, TRICARE, Marketplace Responsibilities: Design provider data, directory-accuracy, and credentialing-workflow scenarios. Build/maintain automation; test 278 and 270/271 transactions. Validate 835 payment linkage and lead feature-level triage Own offshore provider test design across LOBs. Drive automation coverage and mentor analysts. Conduct RCA on directory/network and authorization discrepancies. Design provider data, directory-accuracy, and credentialing-workflow scenarios. Build/maintain automation; test 278 and 270/271 transactions. Validate 835 payment linkage and lead feature-level triage Own offshore provider test design across LOBs. Drive automation coverage and mentor analysts. Conduct RCA on directory/network and authorization discrepancies.