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Responsibilities of Healthcare tester manual Facets Testing

Facets Testing explained


Facets Testing is not one of the testing types. But it is purely and most of the
time, a type of manual testing which is done on Facets tool that is being used
for claims processing and other healthcare insurance company day to day activiti
es are done.
These are Typical healthcare manual testing/ tester roles and responsibilities
especially in FACETS application in healthcare industry.
Participated in requirements meetings to understand the requ
irements from business people.
Prepared Test cases and Test scripts from the requirements a
nd Functional, Technical specifications.
Validated member eligibility and eligibility inquiry in the
facets application to the legacy application in order to confirm the migration s
uccessful or not.
Experience in Medical, Pharmacy Plan changes from one plan t
o other plan with in Group, subgroup, class combinations.
Experience with COB (coordination of benefits) application w
ith in facets, testing of claims status for selected subscribers.
Writing test cases and test scripts in MS Excel Manually and
uploading in Quality center.
Well experienced in benefit coding of different products for
various plans of BCBS such as Blue preferred, Blue exchange etc..
Calculating co-pay, coinsurance, adding single tier, multi t
ier for different products with in a plan.
Comparing plan and product details in medical module, and re
viewing the benefit summary and feeding them into pivot tables with appropriate
co-pay and coinsurance and valid comments for various codes of vision, maternity
etc..
Test data entry into FACETS4.7 application in the test envir
onment for creating groups, subscribers and family members.
Experience in creating new groups, subgroups, subscribers as
and when needed which is later used as a test data for testing purpose.
Experience in System testing and UAT testing of the facets c
ore application and custom modules as needed.
Claims validation in Facets application which includes claim
s pending status, member status, etc..
Creating test cases, test scripts for various modules, and u
ploading them into quality center.
Traceability matrix of test cases to corresponding requireme
nts.
Running the test cases and it scripts and executing them tho
roughly with pass/fail status.
Entering defects for failed test cases and assign the defect
s to appropriate developers.
Regression testing of the application once the defects are f
ixed and passing the test cases.
In simple words, Facets testing is not really much different than other types of
testing except the fact that the domian knowledge in healthcare industry is a m
ust and familiarity on facets tool is necessary.
Major applications with in the Facets testing that you need to learn /know befor
e interview is, Claims processing, hospital, claims, physician claims, member su
bscriber inquiry etc..
facets testing facets healthcare facets testing interview questions what is face
ts testing
Points to Remember
------------------------
Facets is an integrated health care management system designed to handle the com
plex requirements of managed care programs
It is comprehensive client/server based system that integrates eligibility, prov
ider and plan/product data to efficiently process cliams, utilization management
, reviews, case management and customer service information
Facets also handles premium billing, commissions, capitation, and reporting need
s. Facets is a modular system, allowing sierra to select components to meet its
key business needs.
Facets includes an extensive range of detailed processing and maintainance appli
cations that enable Users to control many aspects of managed health care functio
ns

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