What are the responsibilities and job description for the Benefit Plan QA Specialist position at ProCare Rx?
The Benefit Plan QA Specialist is responsible for auditing new plan/group implementation setups to ensure all plan parameters are accurately in the system. This person is also responsible for testing any modifications to existing plans/groups.
ESSENTIAL DUTIES AND RESPONSIBILITIES Included but not limited to the following:
- Execute QA-related tasks and processes in the QA department.
- Run weekly reports to validate plan flags are set appropriately.
- Run billing reports to validate that all test claims have been reversed before the billing cycle commences.
- Write reports that will produce accurate information needed to validate that plan setups are accurate.
- Review all material at hand to determine if plan changes match requests from the client.
- Work with various departments as needed to have plans updated to satisfy requested changes.
- Document with test claims and reports the items that were tested and approved.
- Write up testing procedures for new functionality.
- Make presentations to your peers as a department learning tool.
- Miscellaneous duties as requested
QUALIFICATIONS AND REQUIREMENTS
- Certified Pharmacy Technician with at least one year experience desired.
- Quality Control experience a plus.
- Experience in testing system applications and reading results highly desired
- Exceptional analytic skills desired.
- Excellent proofreading skills.
- Clear concise written and verbal communication skills a plus.
- Ability to change gears mid steam and adapt to changes as items are reprioritized.
- Excel, Word, Google Sheets, Google Calander skills a plus.
- Knowledge of R&R Reports Works a plus.
PHYSICAL DEMANDS
- Requires sitting, standing, and occasional light lifting.
ProCare Rx will never ask for a financial commitment from an applicant as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our official recruitment team at (678) 248-4755 or email us at HR@procarerx.com.
ProCare Rx is an Equal Opportunity Employer.
