Functional Test Engineer

Any Project specific Prerequisite skills

Functional tester with Healthcare experience + Facets Knowledge + experience in EDI file testing

Detailed JD

Key Responsibilities

Perform functional, integration, and regression testing across healthcare applications [interviewguy.com]
Design and execute test scenarios, test cases, and test data based on business requirements [interviewguy.com]
Validate Facets modules including Claims, Membership, Provider, Billing, and Benefits [linkedin.com]
Conduct EDI testing for HIPAA transactions such as:
834 (Enrollment)
837 (Claims)
835 (Payments)
270/271 (Eligibility)

Verify EDI file structures, mappings, and data transformations across systems [naukri.com]
Execute end-to-end testing of claims lifecycle (submission adjudication payment) [naukri.com]
Identify, log, track, and manage defects using tools like JIRA/ALM [naukri.com]
Perform backend validation using SQL to ensure data integrity [simplyhired.com]
Collaborate with business analysts, developers, and stakeholders for requirement validation and defect resolution [testingsociety.com]
Support UAT cycles and production validation activities [testingsociety.com]
Maintain test artefacts such as test plans, RTM, execution reports, and defect logs [testingsociety.com]

Required Skills & Experience

48+ years of experience in Functional Testing / QA
Strong experience in US Healthcare domain (Payer/Provider)
Hands-on experience with Facets application testing (Claims, Enrollment, Billing, Provider modules) [linkedin.com]
Solid experience in EDI testing (X12 / HIPAA transactions such as 834, 837, 835, 270/271) [hirist.tech]

Strong understanding of:

Claims processing & adjudication workflows
Member enrollment & eligibility
Provider and billing processes [in.jooble.org]
Good knowledge of SQL for backend validation
Experience with test management & defect tracking tools (JIRA, ALM, Azure DevOps)
Familiarity with SDLC, STLC, Agile/Scrum methodologies
Strong analytical, problem-solving, and communication skills

Good-to-Have Skills
Exposure to API/Web services testing (SOAP/REST)
Experience in automation tools (Selenium / Tosca) [hirist.tech]
Knowledge of EDI tools / translators (Sterling, BizTalk, etc.) [naukri.com]
Understanding of HIPAA compliance and healthcare regulations [simplyhired.com]

Typical Functional Areas Tested

Claims Adjudication & Pricing
Member Enrollment & Eligibility
Provider Management
Billing & Payments (835 remittance)
EDI Interfaces & Batch Processing
Integration with upstream/downstream systems