[Skip to main content](#main-content) [OpenNash Jobs](https://jobs.opennash.com/) [Hiring report](/reports/hiring/) · [All Tata Consultancy Services jobs](https://jobs.opennash.com/companies/tata-consultancy-services/) · [Search jobs](/search/) Tata Consultancy Services · Newark, NJ # NASCO claims Specialist Newark, NJ $110,000- $115,000 Last seen on Tata Consultancy Services’s official careers site on August 1, 2026; it may have closed since. [Apply on Tata Consultancy Services’s careers site →](https://ibegin.tcsapps.com/candidate/jobs/422434J) [OpenNash Jobs](https://jobs.opennash.com/) / [Tata Consultancy Services](https://jobs.opennash.com/companies/tata-consultancy-services/) / NASCO claims Specialist ## Job description ### Key Responsibilities - Serve as primary SME for end to end NASCO claims processing across professional, institutional, and pharmacy claims. - Provide strategic direction and domain leadership for claims testing initiatives. - Interpret and guide implementation of complex payer rules, benefit configurations, and provider contracts. - Review and validate regulatory compliance with CMS, HIPAA, Medicare, Medicaid, and commercial plan requirements. - Proactively identify domain risks, gaps, and improvement opportunities in claims workflows. ________________________________________ Testing Strategy & Governance - Define overall NASCO claims testing strategy, scope, and coverage for releases. - Review and approve test plans, scenarios, and test data from a domain correctness perspective. - Ensure comprehensive validation of: - Claims adjudication logic - Pricing and repricing - Accumulators (deductibles, MOOP) o COB and subrogation - Authorizations, edits, and exceptions - Lead UAT planning and execution, including business readiness and sign off. - Own defect triage decisions, prioritization, and root cause analysis. ________________________________________ Stakeholder & Onsite Engagement - Act as single point of contact for claims domain queries at client location. - Partner closely with: - Product Owners - Business Users - Operations teams - Development and QA leads - Facilitate workshops, walkthroughs, and requirement clarification sessions. - Influence decision making by translating business needs into system impacts. ________________________________________ Team Leadership & Mentorship - Mentor junior and mid level testers and analysts on healthcare claims concepts. - Review test artefacts and guide offshore UAT teams to ensure domain accuracy. - Promote best practices in domain driven testing and knowledge sharing. ________________________________________ Required ### Skills & Qualifications Mandatory Domain Expertise - Extensive experience in US Healthcare Insurance – NASCO Claims Processing. - Strong understanding of: - Claims lifecycle and adjudication engines o EDI (837, 835, 270/271) ### Coding standards - ICD 10, CPT, HCPCS, DRG o Commercial, Medicare, and Medicaid plans - Hands on experience supporting core payer platforms. ________________________________________ Testing & Process Excellence - Strong manual testing background with senior level oversight experience. - Expertise in: - Test strategy definition o UAT leadership - Defect governance - Familiarity with Agile, SAFe, or hybrid delivery models. - Experience with test management and defect tracking tools (Jira, ALM, qTest). ### Salary Range $110,000- $115,000 a year TCS Employee Benefits Summary: Discretionary Annual Incentive. ### Comprehensive Medical Coverage Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans. ### Family Support Maternal & Parental Leaves. ### Insurance Options Auto & Home Insurance, Identity Theft Protection. ### Convenience & Professional Growth Commuter Benefits & Certification & amp; Training Reimbursement. ### Time Off Vacation, Time Off, Sick Leave & Holidays. ### Legal & Financial Assistance Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing. #LI-SP1