Custom Software Engineer

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

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