IT QA Lead
Equiliem
Buffalo, NY (In Person)
Full-Time
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Job Description
Key responsibilities include:
Identify and document all impacted systems and integration touchpoints related to athenaIDX changes Design and execute system integration testing (SIT), end to end (E2E), and regression testing Validate data integrity across patient demographics, encounters, orders, charges, coding, claims, and payments Actively test and troubleshoot integration scenarios Partner with Interface, Application, and Vendor teams to resolve defects and integration failures 2. Altera Charge Logic Module ITQA Leadership Serve as ITQA lead and subject matter expert for testing and validation of the Altera Charge Logic Module, ensuring accurate, compliant, and auditable charge capture.Responsibilities include:
Validate rules based charge logic translating clinical activity into defensible charges Test charge workflows embedded within Altera clinical documentationVerify:
Single application review for charge creation Elimination of duplicate documentation and charge review Accuracy and completeness of downstream charge posting to athenaIDX Ensure all charge logic produces a clear, visible audit trail supporting compliance and external audits Validate coding efficiency and accuracy gains through scenario based and production like testing Partner with Compliance, HIM, Coding, and Finance to confirm regulatory and payer requirements are met 3. Dictionaries and Tables Optimization QA Lead QA activities supporting the analysis, revision, addition, and deletion of athenaIDX HPA and BAR dictionaries and tables.Key accountabilities:
Validate dictionary and table configuration changes and mapping accuracy Ensure downstream impacts to charging, billing, claims, reporting, and workflows are fully tested Execute pre and post implementation comparisons of system behavior Support the application of the PICOT framework through measurable test outcomes Validate improvements to: Patient account data integrity Accounts receivable throughput System stability and configuration consistency 4. Edits and Hold Bills QA Oversight Provide hands on QA leadership for projects focused on optimizing Edits and Hold Bills within athenaIDX HPA and BAR ETM.Responsibilities include:
Validate removal, revision, or creation of edits and hold bills Test scenarios for: Duplicative edits Ambiguous or unclear logic Edits better managed via workflows or personnel processes Validate TES Edits being converted to Hold Bills Execute comparative testing and analysis of: DNFB A/R Days EDI rejections Denial rates Ensure changes improve operational efficiency without introducing compliance or financial risk 5.ETM & EDI
Workflow QA Leadership Lead QA efforts for ETM and EDI related workflow redesign projects.Key responsibilities:
Validate redesigned ETM worklists aligned with revised edits and hold billsEnsure:
Clear and distinct workflows, including EDI rejections Workflow alignment to defined user roles Test charge triggered and claim triggered workflows Validate reduction in EDI claim rejections through scenario based testing Partner closely with Revenue Cycle Operations to ensure workflows are usable, intuitive, and operationally sustainable 6. Denial Prevention Support Support the Denials Management Committee (DMC) through targeted QA analysis and validation.Focus areas include:
Identification and testing of upstream system issues contributing to preventable denials Validation of fixes tied to: Medical necessity Prior authorization Site of service rules Oncology specific coding and infusion workflows Clinical trials billing Pharmacy and 340B considerations (where applicable) Support denial trend analysis by validating operational and system changes before deployment 7. Leadership & Governance Serve as ITQA lead for RCM Transformation initiatives, setting testing standards, methodologies, and documentation expectations Develop and manage comprehensive test plans, test scripts, defect logs, and validation sign off Communicate risks, defects, readiness assessments, and quality outcomes to program and executive leadership Enforce disciplined change management and release readiness criteria Required Qualifications Bachelor's degree in Information Systems, Healthcare Administration, Business, or related field strongly preferred 10+ years of experience in healthcare IT, with deep revenue cycle and QA/testing expertise Extensive hands on experience with athenaIDX HPA and BAR Strong understanding of: Charge capture and coding workflows Hospital billing and AR processes ETM and EDI workflows Denials management in oncology or complex hospital environments Proven experience leading system integration and end to end testing in large healthcare organizations Demonstrated ability to be both hands on and strategically influential Preferred Experience Oncology or academic medical center experience strongly preferred Experience with Altera clinical and charge logic workflows Familiarity with 3M/Solventum, WellSky, Cerner, PICIS, and pharmacy systems (e.g., Pyxis) Experience supporting enterprise level RCM transformation initiatives Key Competencies Exceptional analytical and problem solving skills Strong leadership presence with ability to influence without authority Deep understanding of revenue integrity and compliance Ability to translate technical findings into operational and financial impact Highly organized, detail oriented, and outcomes driven Excellent communication skills across technical and non technical audiences Important DetailsSimilar remote jobs
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