Senior Healthcare Payer Claims QA Engineer

Senior Healthcare Payer Claims QA Engineer

About the role

As a Senior Quality Engineer - Healthcare Claims Testing, you will make an impact by ensuring the quality, accuracy, and reliability of healthcare payer claims processing solutions through comprehensive testing, automation, and data validation. You will be a valued member of the Quality Engineering team and work collaboratively with business analysts, product owners, developers, healthcare operations teams, and client stakeholders to deliver high-quality healthcare solutions.

In this role, you will:

• Analyze healthcare claims requirements, business rules, and user stories to develop comprehensive test strategies, test scenarios, and test cases aligned with business objectives.
• Execute functional, integration, regression, and end-to-end testing across healthcare claims processing workflows, ensuring accurate adjudication outcomes.
• Validate pre-adjudication logic, claim edits, rejects, pend scenarios, pricing calculations, and downstream claims processing activities.
• Perform EDI/X12 transaction testing, with a focus on 837 Professional (837P), 837 Institutional (837I), and related healthcare claims interfaces.
• Conduct SQL-based data validation, reconciliation, and test data preparation to support testing activities and ensure data integrity.
• Investigate defects, perform root cause analysis, collaborate with development teams, and drive issues through successful resolution.
• Develop, maintain, and execute automated test scripts using Selenium, Playwright, or comparable automation frameworks.
• Perform API and integration testing to validate data exchange between payer platforms, claims systems, provider interfaces, and downstream applications.

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're 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 discipline.
• 7+ years of experience in software testing within Healthcare Payer claims processing environments.
• Strong understanding of the healthcare claims lifecycle, including pre-adjudication, business validations, claim edits, rejects, pend processing, and claims outcomes.
• Hands-on experience testing EDI/X12 healthcare transactions, particularly 837 Professional (837P) and 837 Institutional (837I) transactions.
• Advanced SQL and database testing skills, including backend validation, data analysis, and reconciliation activities.
• Experience performing API, integration, and end-to-end testing across complex healthcare ecosystems.
• Strong defect management, root cause analysis, and problem-solving capabilities.
• Experience working within Agile delivery environments using modern testing and quality engineering practices.

These will help you stand out

• Experience working with PEGA-based healthcare solutions.
• Hands-on automation testing experience using Selenium, Playwright, or similar automation frameworks.
• Knowledge of healthcare payer platforms, claims adjudication engines, and provider integration models.
• Experience leveraging AI-powered testing tools and Generative AI capabilities for test case generation, test optimization, defect prediction, and quality engineering acceleration.
• Exposure to CI/CD pipelines and test automation strategies supporting continuous delivery initiatives.

Benefits:

Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

• 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.
  

Compensation

The annual salary for this position ranges from $90,000 to $112,500, depending on experience and qualifications. This role is also eligible for Cognizant’s discretionary annual incentive program, subject to performance and applicable plan terms.

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

À savoir avant de postuler

• Autorisation de travail: Cognizant ne prendra en considération que les candidats à ce poste qui sont légalement autorisés à travailler au Canada sans avoir besoin d'un parrainage de l'employeur, aujourd'hui ou à l'avenir.
• Mesures d’adaptation: Si vous avez un handicap qui nécessite des mesures d’adaptation raisonnable pour effectuer une recherche d’emploi ou poser une candidature, veuillez envoyer un courriel à [email protected] avec votre demande et vos coordonnées.
• L’IA dans notre processus de recrutement: Nous utilisons des outils d'intelligence artificielle (IA) pour trier et évaluer les candidatures efficacement. Notre équipe examine ensuite les candidatures et décide qui passe à l’étape suivante.
• Poste à pourvoir: Sauf indication contraire, ce poste est actuellement vacant et nous cherchons à le pourvoir.
• Exigences linguistiques: Nous demandons à tous les candidats de posséder une connaissance de base de l’anglais afin de faciliter les communications internes. Pour les postes au Québec, la capacité à communiquer efficacement en anglais est requise car vous fournirez des services à et collaborerez avec des parties prenantes anglophones situées hors de la province.
• Inclusion: Cognizant est un employeur souscrivant au principe de l’égalité d’accès à l’emploi. Votre candidature et votre dossier ne seront pas examinés en fonction de la race, de la couleur, du sexe, de la religion, des croyances, de l'orientation sexuelle, de l'identité de genre, de l'origine nationale, du handicap, des renseignements génétiques, de la grossesse, du statut d'ancien combattant ou de toute autre caractéristique protégée par les lois fédérales, provinciales ou locales.

À propos de Cognizant
Cognizant (NASDAQ: CTSH) est un AI Builder et une entreprise de services numériques (ESN) élaborant des solutions complètes d’IA maximisant les investissements pour des résultats concrets. Sa profonde expertise des métiers, des processus et des technologies lui permet d’intégrer dans les systèmes technologiques le contexte unique de chaque organisation de l’ingénierie à la production à l’échelle. Son objectif: améliorer l’efficacité des équipes, créer de la valeur et permettre aux grandes entreprises de rester performantes dans un monde qui évolue rapidement. Pour en savoir plus: cognizant.ai ou @cognizant.