Healthrules/ Healthedge Configuration SME
Healthrules/ Healthedge Configuration SME
Posted on :
15-06-2025
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1 Vacancy
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Job Description
Healthedge/ Healthrules Configuration SME (with HealthRules Payor (HRP) experience)
100% Remote
6 months
Key Responsibilities:
- Develop and execute test strategies and scripts using HealthRules Language (HRL).
- Validate benefit configurations plan design and logic within the HRP platform.
- Perform end-to-end testing of member benefits including copays coinsurance accumulators and claim adjudication logic.
- Work with BA and config teams to interpret benefit requirement documents (BRDs) and translate them into test cases.
- Identify configuration errors and work with cross-functional teams to resolve issues.
- Automate benefit validation and testing using HRL and available tools.
- Participate in test planning defect triage and release support activities.
- Prepare testing documentation including traceability matrices test data sets and test summary reports.
Required Skills:
- Proficiency in HRL (HealthRules Language).
- Strong experience with HealthRules Payor (HRP) platform.
- In-depth understanding of healthcare benefits claims processing and member enrollment.
- Experience in testing benefit plan logic and configuration.
- Ability to create and manage complex HRL scripts for validation purposes.
- Familiarity with HIPAA standards especially 834/837 transactions (preferred).
- Experience with SQL for backend data validation.
- Knowledge of Agile methodologies and tools like JIRA Confluence etc.
Employment Type
Full Time
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