About this role
Project Role : Custom Software Engineer Project Role Description : Develop custom software solutions to design, code, and enhance components across systems or applications. Use modern frameworks and agile practices to deliver scalable, high-performing solutions tailored to specific business needs. Must have skills : Business Process Analysis Good to have skills : Test Automation Strategy Minimum 3 year(s) of experience is required Educational Qualification : 15 years full time education
Claims/Data Specialist – BA/QA - Healthcare EDI Experience - 5–10+ Years
Summary BA/QA professional bridging business and technology for healthcare claims and EDI integrations — ensuring accuracy, compliance, and data integrity across payer operations. Responsibilities - BA - Requirements elicitation, user stories, process mapping, gap analysis, UAT support Agile ceremonies - Claims - End-to-end lifecycle — Intake, Adjudication, COB, Pricing, Payment, Appeals - EDI - 837P/I/D, 835, 277, 999, TA1, 270/271, 276/277, 278, 834 - QA/Testing - Functional, Integration, E2E, Data Validation, Regression, UAT - Data - SQL-based profiling, reconciliation, root cause analysis across claims systems and EDI gateways - Defects - Log, triage, manage through closure support release readiness and production validation Required Skills Domain - U.S. Payer ops, Claims adjudication, HIPAA EDI, ICD-10, CPT, HCPCS, DRG Technical - Advanced SQL, EDI parsing, API testing (Postman/SoapUI), JSON/XML, Data mapping Tools - JIRA Azure DevOps, qTest, SQL Server, Snowflake, Databricks, Power BI Preferred: Facets, QNXT, HealthRules, Edifecs, TriZetto, FHIR/HL7, ISTQB/CBAP/CSM Success Metrics - Fewer claim defects, Higher EDI acceptance, Better data quality, Faster releases
Additional Information - - The candidate should have minimum 5 years of experience in Business Process Analysis. - This position is based at our Hyderabad office. - A 15 years full time education is required.
15 years full time education
About Accenture Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 791,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities.Visit us at www.accenture.com
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We believe that no one should be discriminated against because of their differences. All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, military veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by applicable law. Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.