Sdet Engineer- Enrollment

Job Title: Senior EDI SDET - Benefit Enrollment & Maintenance (Tosca / Playwright) Experience: 6+ Years Location: Pune, Hyderabad, Chennai, Vadodara and Bengaluru Shift: 2 PM - 11 PM Job Description: Healthcare Domain - Member enrollment & eligibility X12 834 maintenance, retro adjustments, deeming, 820 premium linkage, reconciliation across Medicaid/MA/Duals/MMP/TRICARE/Marketplace Core Skills Needed - Facets (REQUIRED), X12 EDI (834, 820, 270/271), SQL, TOSCA, ADO, enrollment reconciliation Core technical & domain requirements: Facets REQUIRED: membership/enrollment module testing, subscriber/member configuration, and 834-to-Facets data flow validation X12 EDI: 834 (Benefit Enrollment & Maintenance) full transaction expertise Member add/change/term, dependent handling, dual-enrollment scenarios Retroactive adjustments and deeming logic (Medicaid/MMP/Dual) 820 (Premium Payment) validation linkage Member eligibility cross-validation (270/271 correlation) Enrollment reconciliation: source system vs. downstream (enrollment DB claims eligibility) SQL for member-level data comparisons (effective dates, plan codes, LOB flags) TOSCA or similar automation tool LOB knowledge: Medicaid, Medicare Advantage, Duals/MMP, TRICARE, Marketplace Responsibilities: Design enrollment scenarios including retro, term, and dual-enrollment. Build/maintain automation; lead 820 linkage and 270/271 correlation testing. Lead reconciliation between 834 source and downstream member records. Own offshore enrollment test design across LOBs and deeming logic. Drive automation coverage and mentor analysts. Conduct RCA on eligibility and reconciliation discrepancies.