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Edifecs QA Analyst | USA Remote

Remote · New Zealand Full-time

Hi, Greetings! We have an exciting opportunity for an experienced Edifecs QA Analyst with our client. Job Title: Edifecs QA Analyst Location: USA – Remote Total Experience: 4–6 Years Key Responsibilities: Analyze HIPAA implementation guides and payer companion guides to develop comprehensive test scenarios. Create, maintain, and execute EDI test files covering positive, negative, and edge-case scenarios. Validate healthcare claims using Edifecs against HIPAA standards, SNIP levels, and payer-specific rules. Test EDI acknowledgments and responses to ensure accurate error reporting. Perform end-to-end claims testing, from EDI intake through claims processing and adjudication. Use SQL to validate claim data, mappings, and downstream processing results. Required Skills: Hands-on experience with Edifecs for healthcare EDI claims validation. mainframe Strong understanding of HIPAA EDI transactions and healthcare claims processing. Experience creating, reading, and modifying EDI test files. Knowledge of HIPAA SNIP validation levels and payer companion guides. Proficiency in SQL for backend data validation. Understanding of claims submission, adjudication, payment, and claim status workflows. Thanks and regards, Shreya M2S Tech Solutions

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