What are the responsibilities and job description for the Healthcare EDI Test Lead, HIPAA and ANSI X12 position at Amaze Systems?
Hello,
Hope you are doing well,
Role: US Healthcare EDI Test Lead
Location: Philadelphia, PA
Job Description:
We are seeking an experienced US Healthcare EDI Test Lead to oversee and manage the testing of EDI 27X transactions (270/271, 276/277, 278, etc.). The ideal candidate will have a strong background in healthcare EDI transactions, testing methodologies, and compliance with HIPAA and ANSI X12 standards.
Key Responsibilities:
Lead the testing efforts for 27X EDI transactions (Eligibility & Benefit Inquiry/Response, Claim Status, Prior Authorization, etc.).
Develop test strategies, test plans, and test cases for EDI transactions.
Conduct functional, integration, regression, and end-to-end testing of EDI transactions.
Validate EDI files for structure, compliance, and business rules.
Perform data mapping and verification against HIPAA and X12 standards.
Collaborate with business analysts, developers, and external trading partners to resolve EDI-related issues.
Utilize testing tools (e.g., Edifecs, Postman, SoapUI, SQL, etc.) to validate EDI transactions.
Identify, document, and track defects using JIRA, HP ALM, or similar tools.
Ensure compliance with HIPAA, ANSI X12, and other regulatory requirements.
Provide guidance and mentorship to junior testers.
Support UAT (User Acceptance Testing) and coordinate with stakeholders for sign-off.
Required Skills & Qualifications:
10 years of experience in US Healthcare EDI testing.
Strong expertise in EDI 27X transactions (270/271, 276/277, 278, etc.).
Hands-on experience with HIPAA X12, ANSI X12, and EDI validation tools.
Experience with SQL queries to validate backend data.
Familiarity with EDI tools like Edifecs or equivalent.
Strong knowledge of Medicare, Medicaid, and Commercial Payers.
Experience with API testing (SOAP/REST) is a plus.
Excellent problem-solving and debugging skills.
