SDET Engineer - Encounter Data Processing

Job Summary

SDET Engineer - Encounter Data Processing

9-13 Years

Bengaluru

Core Skills

• SDET
• Facets
• TOSCA/Robot Framework
• SQL
• X12EDI

Responsibilities

• Independently design encounter lifecycle scenarios across 837/277CA/999/TA1.
• Build and maintain TOSCA/Robot Framework automation for encounter regression.
• Lead reconciliation between source claims and submitted encounters.
• Own encounter test design and submission-edit validation across LOBs.
• Drive automation coverage and mentor analysts on EDI validation.
• Conduct RCA on rejections and state/CMS edit failures.

Requirements

• Facets (Required): claims module familiarity (encounters are derived from Facets claims data); Facets-to-encounter data validation
• X12 EDI knowledge: 837P, 837I, 837D (Professional, Institutional, Dental) transaction structure, loops, segments
• 277CA (Claim Acknowledgement) and 999/TA1 validation
• Encounter submission & acceptance rules Medicaid, Medicare Advantage, TRICARE, Marketplace
• Edifecs or equivalent EDI validation tooling
• SQL for encounter data validation (claim header, detail, member eligibility cross-checks)
• TOSCA or Robot Framework test automation
• Healthcare payer domain: CMS encounter submission rules, state-specific companion guide

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