Formulary QA Specialist — Quality & Claims Testing

Procare-Rx; Gainesville (FL); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Comprehensive Health Benefits

401(k) with company match

Paid vacation and holidays

Employee Wellness Program

Job summary

ProCare Rx in Gainesville is seeking a Certified Pharmacy Technician to support Benefit/Formulary Implementation and Quality Assurance on-site. The role includes executing QA tasks, validating plan flags, and ensuring test claims are reversed before billing cycles.

The ideal candidate has at least one year of pharmacy tech experience, strong proofreading skills, and the ability to adapt to changing priorities. ProCare Rx offers a comprehensive benefits package and a supportive team environment.

Qualifications

• 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
• Excellent proofreading skills.
• Clear concise written and verbal communication skills a plus.
• Ability to change gears mid stream and adapt to changes as items are reprioritized.
• Excel, Word, Google Sheets, Google Calendar skills a plus.
• Knowledge of R&R Reports Works a plus.

Responsibilities

• 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

Skills

Proofreading

Communication

Adaptability

Excel

Education

Certified Pharmacy Technician

Tools

R&R Reports Works

Job description

ProCare Rx in Gainesville is seeking a Certified Pharmacy Technician to support Benefit/Formulary Implementation and Quality Assurance on-site. The role includes executing QA tasks, validating plan flags, and ensuring test claims are reversed before billing cycles.

The ideal candidate has at least one year of pharmacy tech experience, strong proofreading skills, and the ability to adapt to changing priorities. ProCare Rx offers a comprehensive benefits package and a supportive team environment.