QA Tester-Manual
Our direct client is looking for QA Analyst – Payment Integrity and Claims Repricing.
Location: Remote, CTH after 6 months
Please send me your rate, contact details and current location.
Key Responsibilities
Claims Repricing Validation
• Validate claim repricing based on:
• Provider contracts
• Fee schedules (CPT/HCPCS based)
• DRG/APC logic
• Percentage of billed charges
• Medicare-based pricing
• Verify allowed amount, patient responsibility, and payer liability calculations.
• Test in-network vs out-of-network pricing scenarios.
• Validate multiple pricing methodologies (
Functional & Regression Testing
• Creating and executing test cases
• Perform regression testing
• Validate edge cases (
Data Validation
• Write SQL queries to:
• Validate claim financial fields
• Compare expected vs actual allowed amounts
• Identify duplicate claims (TIN, service type, amount)
Documentation
• Create detailed test cases and test scenarios.
• Document pricing discrepancies with calculation breakdown.
• Log defects with reproducible steps and financial impact.
• Maintain traceability matrix.
Apply Now
Apply Now
Location: Remote, CTH after 6 months
Please send me your rate, contact details and current location.
Key Responsibilities
Claims Repricing Validation
• Validate claim repricing based on:
• Provider contracts
• Fee schedules (CPT/HCPCS based)
• DRG/APC logic
• Percentage of billed charges
• Medicare-based pricing
• Verify allowed amount, patient responsibility, and payer liability calculations.
• Test in-network vs out-of-network pricing scenarios.
• Validate multiple pricing methodologies (
Functional & Regression Testing
• Creating and executing test cases
• Perform regression testing
• Validate edge cases (
Data Validation
• Write SQL queries to:
• Validate claim financial fields
• Compare expected vs actual allowed amounts
• Identify duplicate claims (TIN, service type, amount)
Documentation
• Create detailed test cases and test scenarios.
• Document pricing discrepancies with calculation breakdown.
• Log defects with reproducible steps and financial impact.
• Maintain traceability matrix.
Apply Now
Apply Now