Senior Medicare Claims Test Lead

Job Summary

Leading testing initiatives for Medicare claims, the full-time Senior Healthcare Claims Test Lead will independently manage testing activities throughout the project lifecycle, focusing on claims processing, payment accuracy, and defect management, all while working remotely.

Key responsibilities

• Lead end-to-end testing activities for Medicare claims, including test planning, execution, and defect management
• Apply healthcare payer and claims expertise while testing solutions involving HRP, ClaimXten, and/or Cotiviti
• Conduct defect management and root cause analysis for claims processing issues, collaborating with cross-functional teams to drive resolutions

Required qualifications

• 10+ years of strong healthcare payer domain expertise, particularly in claims processing and testing
• Hands-on experience with HRP, ClaimXten, and/or Cotiviti
• Strong experience in Medicare claims testing
• Test management experience with the ability to independently lead testing activities
• Experience with defect management and resolution of complex claims-processing issues