Pega Tester Hybrid in Norfolk, VA, US

• Posted 7 hours ago

• Updated 7 hours ago Contract W2 Contract Independent 12 Months Remote Depends on Experience Fitment Dice Job Match Score™ 🔢 Crunching numbers... Job Details Skills Acceptance Testing Auditing Automated Testing Business Rules Collaboration Continuous Improvement Data Flow Decision Trees Defect Tracking Development Testing Functional Testing HIPAA Health Care Insurance Management Manual Testing Payment Systems Pega Process Improvement Quality Assurance Regression Testing Regulatory Compliance Reporting Scripting System Testing Test Cases Test Execution Test Management Test Scenarios Testing Workflow Acceptance Testing Auditing Automated Testing Business Rules Collaboration Continuous Improvement Data Flow Decision Trees Defect Tracking Development Testing Functional Testing HIPAA Health Care Insurance Management Manual Testing Payment Systems Pega Process Improvement Quality Assurance Regression Testing Regulatory Compliance Reporting Scripting System Testing Test Cases Test Execution Test Management Test Scenarios Testing Workflow Summary Pega Tester Remote/Norfork VA Need to be onsite when Client Expects Analyze requirements and design comprehensive manual test cases and test scenarios for claims workflows within the Pega platform Develop test cases covering end-to-end claims workflows (enrollment, verification, adjudication, denial management, appeals, payment posting); ensure test cases align with business requirements and claims processing rules; document expected results with attention to benefit facet application Execute manual test cases within Pega environments (development, test, staging) to validate claims processing functionality and business rules Perform functional testing of Pega case activities, assignments, and workflows; validate claim adjudication accuracy; test benefit facet configurations (deductibles, copays, coinsurance); verify claim calculations and payment logic Validate Pega business rules engine and claims-specific configurations to ensure accurate claim processing Test Pega rule configurations (Decision Trees, Decision Tables, Constraints); validate claim decision logic and benefit facet rules; verify coverage determination and claim adjustment rules Test integration between Pega claims processing and external systems (eligibility/enrollment systems, medical management platforms, provider networks, payment systems) Validate data flow between Pega and integrated systems; test claim data imports and exports; verify payment posting to external systems; test error handling and data reconciliation Perform regression testing on Pega system updates, patches, and new releases to ensure existing claims functionality remains intact Execute regression test suites following Pega version upgrades; identify and report regressions in claims workflows and business rules; support hotfix validation and patch verification Conduct User Acceptance Testing (UAT) coordination and support, ensuring claims stakeholders can validate business requirements Prepare UAT test scripts and test data; coordinate with business users and claims teams; guide UAT execution; document defects and change requests; support UAT sign-off Document and report test results, defects, and issues using test management and defect tracking tools Create detailed test execution reports; log defects with clear reproduction steps and expected vs. actual results; track defect severity and priority; verify defect fixes through regression testing Collaborate with business analysts to understand claims workflows, benefit structures, and coverage rules impacting test design Communicate with claims domain experts to clarify requirements; validate test scenarios against business logic; identify edge cases and boundary conditions specific to claims processing Validate compliance with healthcare regulations and internal policies in Pega claims workflows Test claim processing logic for compliance with CMS regulations, state insurance laws, and HIPAA requirements; validate deny reasons and appeals workflows; verify audit trail and claim history logging Maintain test artifacts and support continuous improvement of testing processes Organize and maintain test case libraries and test data repositories; update test cases based on requirement changes; contribute to QA process improvements and test automation opportunities. Employers have access to artificial intelligence language tools ("AI") that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id:

91126521

Position Id:

9080505 Posted 7 hours ago