Manual Tester

Product Development

Position Overview

We are seeking a detail-oriented Manual QA Tester to design, execute, and maintain end-to-end manual testing for US Healthcare Revenue Cycle Management (RCM) systems that leverage AI, ML, RPA, GenAI, and Agentic AI. This role focuses on validating business workflows, data accuracy, AI-assisted decisions, automated actions, and regulatory compliance across applications built with .NET Core, MVC, React, SQL, APIs, and cloud platforms. The Manual Tester will ensure quality, security, and compliance of healthcare applications supporting claims, eligibility, denials, payments, patient billing, and collections, while collaborating with automation, AI/ML, RPA, and engineering teams.

Job Roles & Responsibilities

Manual Testing & Full-Stack QA:

• Review business requirements, functional specifications, workflow definitions, and AI/RPA design documents to create detailed manual test plans and test cases.
• Execute manual functional, regression, integration, system, and UAT testing for RCM workflows, including:
  • Insurance eligibility verification
  • Claims submission, adjudication, and reprocessing
  • Denials management and appeals
  • Payment posting and reconciliation
  • Patient billing and collections
• Test full-stack applications built on .NET Core, MVC, React, SQL Server, and REST APIs.
• Validate end-to-end integrations with cloud services, EHR systems, payer portals, clearinghouses, and third-party healthcare applications

AI, ML, GenAI & Agentic AI Validation (Manual):

• Manually validate AI/ML-driven outputs used in RCM workflows, such as:
  • Claim prioritization and routing
  • Denial prediction or classification
  • Payment and collections recommendations
• Validate GenAI-generated content (summaries, notes, recommendations) for accuracy, consistency, explainability, and compliance.
• Test Agentic AI workflows where AI agents make decisions and trigger downstream actions.
• Verify fallback logic, confidence thresholds, and human-in-the-loop controls for AI-assisted processes.
• Validate AI behavior across edge cases, data variations, and exception scenarios

RPA & Intelligent Automation Validation:

• Manually test RPA-driven workflows (attended and unattended) in claims, billing, collections, and reporting.
• Validate handoffs between AI/ML decisioning and RPA execution.
• Verify exception handling, retries, logging, and recovery scenarios for automated workflows.
• Ensure audit trails accurately capture AI decisions and RPA actions.

Integration, Data & Workflow Validation:

• Validate data accuracy across UI, APIs, databases, AI outputs, and reports.
• Perform backend validation using SQL queries to verify balances, adjustments, and transaction integrity.
• Validate workflow orchestration across manual, AI-assisted, and automated components.
• Verify reporting outputs related to AR, collections, and payments.

Collections & Telecom-Aware Testing:

• Validate patient collections workflows, including:
  • Outstanding balance calculations
  • Statement generation and delivery
  • Payment plans and follow-up logic
• Test telecom-enabled touchpoints:
  • Call and SMS triggers
  • Contact attempt logging
  • Consent, opt-in, and opt-out enforcement
  • Time-window and frequency compliance

Ensure complete and accurate audit trails for patient contact activities.

Test Documentation, Defect Management & Reporting:

• Create and maintain test cases, execution reports, defect logs, and traceability matrices.
• Log and track defects related to functional, data, AI behavior, and automation issues.
• Collaborate with developers, data scientists, and RPA engineers to clarify expected behavior and resolve defects.
• Support UAT cycles and release sign-offs with complete documentation

Compliance & Security Validation:

• Ensure testing adheres to HIPAA, SOC 2, and organizational security policies.
• Validate:
  • Role-based access control (RBAC)
  • Secure PHI handling and data masking
  • Audit logs and traceability for AI and RPA decisions
  • Compliance of automated workflows with healthcare and collections regulations
  • Follow documented QA and compliance procedures

Candidate Requirements

• Bachelor’s degree in Computer Science, IT, Engineering, or related field.
• 3–6+ years of experience in manual QA, preferably in US Healthcare or healthcare IT.
• Experience validating AI-assisted or automated workflows in production systems.
• Strong understanding of US Healthcare RCM workflows; collections exposure is a plus.

Technical Expertise:

• Manual Testing: Functional, Regression, Integration, System, and UAT
• Application Platforms: .NET Core, MVC, React
• Databases: SQL Server (data validation)
• APIs: REST API validation
• AI / Automation Awareness: AI/ML concepts, GenAI outputs, Agentic AI workflows, RPA execution validation
• Cloud Awareness: AWS, Azure, or GCP
• Compliance: HIPAA, SOC 2; awareness of HITRUST and healthcare regulatory standards

Skillset:

• Strong analytical skills to validate complex, AI-assisted healthcare workflows.
• Ability to reason about AI outputs and business correctness, not model internals.
• High attention to detail and compliance-first mindset.
• Effective collaboration with engineering, AI/ML, and RPA teams.
• Strong documentation and communication skills.

Strategic Impact:

• Ensure accurate, compliant, and trustworthy AI-assisted RCM workflows.
• Reduce risk from incorrect AI decisions or automated actions.
• Improve audit readiness for AI and automation-driven systems.
• Support safe and scalable adoption of AI, GenAI, and Agentic AI in healthcare operations.

Kindly Note: At Credence, we uphold the highest standards of integrity in our recruitment process. We do not charge any fees at any stage of the hiring process, and we strictly prohibit any third parties, vendors, or individuals from soliciting money in exchange for job opportunities at Credence.

If you are approached by anyone requesting payment or offering you a position at Credence in exchange for money, do not engage with them. Such actions are fraudulent and not authorized by Credence. Please report any such incidents immediately to our official HR team at [email protected]m

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