Claims Adjudication System Tester​/Validator

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Full Time Elkridge, MD, US

4 days ago Requisition

Claims Adjudication System (Tester/Validator)

The APWU Health Plan is seeking a Claims Adjudication System Tester/Validator to join our Testing Department.

This position is responsible for developing and validating test plans, conducting acceptance and regression testing for the health claims processing system and other interactive systems.

• Primarily focusing on testing and validation for upgrades, add-ons, benefit changes and continued maintenance of the QNXT claims processing system.
• Testing and validation of all business-related applications.
• Work with Health Plan Business Analysts (and others as needed) to ensure that test plans and scenarios cover all testable requirements and provide detailed feedback to the Information Technology staff related to application set‑up or possible design flaws.
• Keep detailed testing documentation including screen prints of system set‑up and testing results, both positive and negative.
• Review and/or develop reports as needed to ensure thorough testing as well as to identify trends in system issues.
• Identify innovative methodologies to guarantee that tests are as fail‑safe as possible and that potential fallout from fixes is tested.
• Document details of bugs found during testing and notify affected parties.
• Schedule status meetings as necessary to include all affected parties.
• Maintain and/or enhance system skills as needed to sustain a superior knowledge of the Plan’s workflow, policies, procedures and system(s) capabilities.
• Work hours outside of normal work day/week when necessary.
• Other duties as assigned.

• 2-4 years software testing experience or 5+ years of experience in testing methodology and practical application in a healthcare environment.
• A minimum of 3 years healthcare claims processing, review or support staff experience.
• Excellent verbal and written communication skills.
• Excellent problem solving and issue identification skills.
• Ability to work well independently.
• Proficiency with Microsoft Suite.
• SQL knowledge preferred.
• Experience with the QNXT system is preferred.
• Experience and proficiency with claims editing software.
• Experience and proficiency with Claim Test Pro a plus.
• Experience with automated test tools a plus.
• A.A. degree and professional industry certification preferred.

Please ensure all of the above requirements are clearly reflected in your resume or specifically addressed in your cover letter. Stated salary requirements (range is acceptable) are required for consideration. No relocation assistance available. Must pass criminal records check prior to employment. Please apply on-line.