QA Engineer - Healthcare Provider Data Management

Position Overview

We are seeking a QA Engineer specializing in healthcare provider data management to join our team in Hyderabad. The role focuses on ensuring data integrity and accuracy across provider directories, credentialing, prior authorizations, eligibility, and payment linkage within Medicaid, Medicare Advantage, Duals, TRICARE, and Marketplace lines of business.

Key Responsibilities

• Create and design comprehensive testing scenarios for provider data, directory accuracy, and credentialing workflows.
• Develop and maintain automation scripts, particularly for 278 (prior authorization) and 270/271 (eligibility) transaction testing.
• Validate 835 payment remittance linkages accurately to provider payments and lead detailed feature-level triage processes.
• Lead and manage offshore teams responsible for provider test design across multiple lines of business.
• Promote automation test coverage enhancements and provide guidance to analyst teams.
• Perform root cause analysis for discrepancies in provider directories, network status, and authorization processes.

Required Technical and Domain Expertise

• Hands-on experience with Facets, including provider, contract, and network module testing and configuration validation (mandatory).
• Proficient knowledge of X12 EDI standards, particularly 278 (Prior Authorization request/response), 270/271 (Eligibility and Benefit inquiries/responses), and 835 (payment remittance).
• Strong understanding of provider demographic data elements such as NPI, TIN, taxonomy codes, specialty, address, and network affiliation status.
• Testing experience in provider enrollment and credentialing workflows including additions, updates, terminations, and reactivations.
• SQL skills to perform provider data cross-validation among master data, claims, eligibility, and directory records.
• Experience using TOSCA or equivalent automation testing tools.
• Familiarity with provider data management across Medicaid, Medicare Advantage, Duals/MMP, TRICARE, and Marketplace business lines.

About Ascendion Engineering

Ascendion Engineering Private Limited is an India-based firm delivering technology-driven engineering and professional services. The company offers a collaborative environment fostering continuous learning and career growth within the technology and engineering fields.