Software testing jobs healthcare domain

The program is generally to find poor and unwed young mothers to be who may need assistance. Patients related images like x-ray, scanning reports etc. Client : MacBee Health Group, USA Description: This product is related to Health Care domain, which involves the Policy Holders, Members of the Policy, Member Designees, Providers, and Business Units etc who can call the call center and ask for some specific services thereby the CSR selects the appropriate search mechanism to validate the caller and then performs the required services to the caller viz.

System Integration Testing. Validate the feed to members system, finance system, claim system, and provider portal. Login and view providers details, claim status, and member details Make change request to change the name, address, phone number, etc. View the member details with an invalid ID Login with invalid credentials. Login and view details about broker and commission payment Make a request to change the name, address, phone number, etc. It should be capable of edit, enter and save broker data Broker commission calculation based on the premium payment details from the member system.

Enter, save and edit brokers record for different types of broker For active brokers calculate the commission by creating a feed file with the respective record for members with a different plan.

Enter a broker record with incomplete data and save for different types of broker By creating the feed file with the respective record for members with different plan calculate the commission for the terminated broker By creating the feed file with the respective record for members with different plan calculate the commission for the invalid broker. To downstream system such as finance system, broker portal and member system validate the feeds Validate if the changes from broker portal are incorporated in the respective broker record.

Enroll, reinstate and terminate a member Remove and add a dependent Generate premium bill Process premium payments. With the current, past, and future effective dates enroll different types of members Inquire and change members Produce premium bill for an active member for the following month Terminate an active member with past, current and future termination dates greater than the effective date Re-enroll a terminated member with current, past and future effective dates Reinstate a terminated number.

With insufficient data enroll a member For a terminated member produce a premium bill for the following month. Validate the feed to downstream systems such as provider portal, broker portal, finance system, and claim system Validate if the alterations from member portal are incorporated in the respective member record Process the payment of premium bill generated with the feed from members portal that has details of payment made.

Claims in health-care should edit, enter and process claims for a member as well as dependent For invalid claims, it should throw errors when incorrect data is entered.

It should include the scenario to edit, enter and process claims for a member as well as dependent. It should validate and enter a claim with invalid procedure code and diagnosis code Validate and enter a claim with the inactive provider ID Validate and enter a claim with a terminated member.

It should include a scenario to validate the feed to downstream systems such as provider and finance portal. It should check whether correct account number or address is chosen for the respective member, provider or broker for the payment. Verify whether payment is done for an invalid member, provider or broker ID by creating a respective record in the feed Verify whether payment is done for an invalid amount for the member, provider or broker by creating respective records in the feed.

Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers. The health care industry, or medical industry, is a sector that provides goods and services to treat patients with curative, preventive, rehabilitative or palliative care. The modern health care sector is divided into many sub-sectors, and depends on interdisciplinary teams of trained professionals and paraprofessionals to meet health needs of individuals and populations.

This article provides an overview of medical industry. This article provides a short history of healthcare industry and discusses major world events that impacted and shaped the healthcare industry as it stands today. This article briefly traces global healthcare history from ancient times to colonial era to the modern day.

This article also discusses various ideologies that have dictated the path of global health and set the trend towards globalization of healthcare sector. Health Care or Health Insurance is similar to general insurance. As you know, in any insurance, insurer Insurance company will provide the plans and customer Subscriber or Policy holder will buy policy of his desired plan.

Insurer will receive the premium amount from the policy holders and the policy Holders will get reimbursements from insurer for the valid claims they have submitted. Insurer: An entity which creates plan, sell policy and reimburses policy holder or provider for the submitted valid claims.

Provider: A person or an entity, which provides the health care service to the policy holder and their dependents, either receives payment for the service from the policy holder or from the insurer by submitting a claim.

TPA: A person or an entity that manages the claims of policy holder or provider and receives payment for the management from the respective contributor. BROKER: Healthcare insurance broker As you have guessed, he is an agent who sells policy to the customers on behalf of insurer and receives commission in return from the Insurer. Subscriber — Person who pays the premium and under whom the family is covered. Member — Who receives medical coverage under a subscriber.

Dependents of the family. Coinsurance — A form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible amount, if any, was paid. Copayment — A form of medical cost sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received.

The insurer is responsible for the rest of the reimbursement. Deductible — A fixed dollar amount during the benefit period — usually a year — that an insured person pays before the insurer starts to make payments for covered medical services. FSA Flexible spending accounts or arrangements — Accounts offered and administered by employers that provide a way for employees to set aside, out of their paycheck, pretax dollars.

Can pay only medical expenses. Money lost if unused.