Claims (Medicaid) Test Manager at American Cybersystems, Inc. in St. Louis, Missouri
Posted in Other about 3 hours ago.
Job Description:
Innova Solutions is immediately hiring a Claims (Medicaid) Test Manager
Position type: Contract
Duration: 12 Months
Location: St. Louis MO, USA
As a Claims (Medicaid) Test Manager, you will:
We are looking for Manual Claims Test Manager, preferably with MMIS (Medicaid Management Information System) experience. If MMIS expertise is not available, candidates with payer experience in claims are also suitable, particularly those with skills in EDI (Electronic Data Interchange), accumulators management, and claim financials.
- Design, develop and implement test plans, test cases and test strategies tailored to claim processing systems (including Medicaid claims)
- Prepare and maintain clear, detailed test documentation, including test plans, test cases and results
- Design and Develop Test Automation framework
- Collaborate with business analysts, developers and stakeholders to understand requirements and translate them unto comprehensive testing scenarios
- Participate in all Agile ceremonies and represent the QA testing team
- Perform functional, regression, integration and end to end testing of claims processing systems (including Medicaid claims)
- Validate claims adjudication logic, compliance with Medicaid policies and processing workflows
- Conduct data validation and verify accurate data transformation across system components
- Ensure test aligns with regulatory requirements, including HIPPA and Medicaid guidelines
- Verify compliance with industry standards for claims data processing and security
- Provide periodic reports on testing progress, coverage, and quality metrics to project stakeholders
- Participate in peer reviews to test cases and scripts
- Monitor and Mentor junior & Sr. QA testers
- Proven experience in managing a testing team of 5-7 testers (both junior and senior)
- Proven experience in claims processing, with a strong preference for MMIS experience.
- Alternatively, significant payer experience in claims, particularly with EDI, accumulators, and claim financials.
- Technical proficiency in claims processing systems and related software.
- Strong analytical skills and attention to detail.
- Effective problem-solving abilities.
- Excellent verbal and written communication skills.
- Good SQL skills
- Good Excel skills
- Ability to work effectively in a collaborative environment
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.
Thank you!
Kiran Vajrala
Manager
PAY RANGE AND BENEFITS:
Pay Range*: 82,500 $ - 97,000 $ Per Year
*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.
Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).
ABOUT INNOVA SOLUTIONS:Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.
Recent Recognitions:
- Named One of America's Best Employers for New Grads by Forbes (2024)
- Named One of the Best Companies to Work For by U.S. News & World Report (Private Companies List, 2024-2025)
- One of the Largest IT Staffing Firms in the US - Ranked #3 by Staffing Industry Analysts (SIA, 2024)
- One of the Largest Staffing Firms in the US - Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
- Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
- One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
- AWS Advanced Tier Services Partner with 100+ certifications
Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@innovasolutions.com or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.
The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.
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