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QA Test Engineer with Medicaid - 100% Remote

Work from home Full-time role Hiring

• Minimum of 7 years of Quality Assurance or software testing experience, preferably in healthcare, PBM or pharmacy claims environments.

  • Hands-on experience testing pharmacy claims, claim adjudication, eligibility, benefits, pricing, accumulators, reject codes, and claim response messaging.
  • Working knowledge of NCPDP Telecommunication Standard Version D.0; exposure to Version F6 implementation or standards migration is strongly preferred.
  • Experience creating test plans, test cases, test scripts, test estimates, test data, and traceability matrices.
  • Strong understanding of SDLC methodologies, including Agile, Scrum, Waterfall, Iterative, or hybrid delivery models.
  • Solid SQL experience for backend validation, data reconciliation, and claims data analysis.
  • Experience with defect management, test execution tracking. QA reporting, and release validation.
  • Ability to interpret transaction layouts, payer sheets, field-level requirements, business rules, and technical mapping documents.
  • Strong analytical, troubleshooting, organizational, documentation, and problem- solving skills.
  • Effective written and verbal communication skills with the ability to explain testing results, defects, and implementation risks to technical and business audiences.
  • Ability to work independently and collaboratively in a fast-paced implementation environment.

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