Senior Healthcare Payer Claims QA Engineer

Cognizant • Madison, WI • 2h ago

About the role

As a Senior Healthcare Payer Claims Test Engineer , you will help ensure the quality, accuracy, and reliability of healthcare payer claims-processing applications and integrations. You will work closely with business, development, and quality engineering teams to validate complex claims workflows, EDI/X12 transactions, backend data, and downstream claim outcomes.

In this role, you will

Analyze healthcare claims requirements, user stories, and business rules to develop comprehensive test scenarios and test cases.

Execute functional, regression, integration, and end-to-end testing across healthcare payer claims-processing workflows.

Validate the claims lifecycle, including pre-adjudication logic, business validations, claim edits, rejects, pend scenarios, and downstream claim outcomes.

Perform EDI/X12 transaction testing with a strong focus on 837 Professional (837P) and 837 Institutional (837I) transactions and related healthcare claims interfaces.

Perform SQL and database validation, data analysis, reconciliation, and test-data preparation to support test execution.

Conduct API and integration testing to validate accurate data exchange between upstream and downstream applications.

Investigate defects, perform root-cause analysis, collaborate with development teams, and drive issues through resolution and closure.

Develop, maintain, and execute automated test scripts using Selenium, Playwright, or similar automation frameworks, while leveraging AI-assisted testing techniques where applicable.

Work model

We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a Remote position open to qualified applicants in the United States .

Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.

The working arrangements for this role are accurate as of the date of posting. This may change based on the project you are engaged in, as well as business and client requirements. Rest assured, we will always be clear about role expectations.

What you need to have to be considered

Bachelor's degree in computer science, Information Technology, Engineering, or a related field.

8+ years of software testing experience within Healthcare Payer claims-processing environments .

Strong hands-on experience testing Healthcare Payer claims applications and workflows .

Strong understanding of the end-to-end claims' lifecycle, including pre-adjudication, business validations, claim edits, rejects, pend processing, and downstream claim outcomes.

Hands-on experience testing EDI/X12 healthcare claims transactions, particularly 837P and 837I.

Strong SQL and database-testing skills, including backend data validation, reconciliation, and test-data preparation.

Experience creating and executing functional, regression, integration, and end-to-end testing for complex claims-processing workflows.

These will help you stand out

Knowledge of PEGA-based healthcare solutions.

Experience with API and integration testing using modern testing tools and methodologies.

Hands-on automation experience using Selenium, Playwright, or similar test-automation frameworks.

Experience using AI-powered testing tools or GenAI capabilities for test-case generation, test optimization, automation acceleration, defect prediction, or other quality-engineering activities.

We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.

Salary and Other Compensation

The annual salary for this position is between $96,000 to $110,000 depending on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.

Benefits

Medical/Dental/Vision/Life Insurance

Paid holidays plus Paid Time Off

401(k) plan and contributions

Long-term/Short-term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

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