Pharmacy Quality Assurance Coordinator

Medix; Plano (TX); On-site; USD 33,000 - 37,000; Full time

Benefits offered by this job

Paid Sick Leave

Health Benefits

401k

Short Term Disability Insurance

Term Life Insurance

Job summary

Medix is seeking a QA Coordinator to ensure patient files are complete, accurate, and audit-ready by reviewing documentation, authorizations, and clinical notes. This role acts as the final defense against denials and supports specialty pharmacy and infusion workflows.

Onsite in Plano, TX, the position requires attention to detail, ability to work across multiple systems, and collaboration with operations, insurance, and QC teams to maintain compliant patient records.

Qualifications

• Experience in specialty pharmacy, infusion pharmacy, healthcare operations, or medical insurance workflows preferred.
• Knowledge of prior authorizations, benefits verification, medical benefits, or reimbursement processes strongly preferred.
• Strong critical thinking and problem-solving skills.
• Ability to work independently in a fast-paced, detail-oriented environment.
• Comfortable reviewing large amounts of documentation across multiple systems.
• Strong organizational and communication skills.
• High attention to detail and auditing mindset.

Responsibilities

• Review completed patient work orders for accuracy and completeness.
• Audit documentation to ensure files are compliant and audit-ready.
• Verify authorizations, approvals, therapy changes, and operational documentation align correctly.
• Review provider and pharmacist progress notes to ensure therapy interventions are properly supported.
• Investigate discrepancies across multiple systems and portals.
• Validate approved services and assist with accurate patient co-pay quoting.
• Identify missing documentation, inconsistencies, or operational gaps that could lead to denials.
• Collaborate cross-functionally with operational, insurance, pharmacy, and QC teams.
• Maintain strong attention to detail while managing high-volume documentation review workflows.

Skills

Specialty pharmacy

Infusion pharmacy

Healthcare operations

Medical insurance workflows

Prior authorizations

Benefits verification

Critical thinking

Independent work

Documentation review

Tools

Health portals

Job description

Job Summary

The QA Coordinator ensures patient files are complete, accurate, compliant, and audit-ready by reviewing documentation, therapy changes, authorizations, operational workflows, and supporting clinical notes. This role acts as the final line of defense in preventing denials and ensuring operational accuracy. This is an excellent opportunity for someone with experience in specialty pharmacy, infusion operations, benefits verification, authorizations, or medical insurance workflows who enjoys detail-oriented work and critical thinking.

Details

• Shift: Mon-Fri (8:30am-5pm), Onsite
• Location: Plano, TX
• Pay: $24.00 - $27.00

Key Responsibilities

• Review completed patient work orders for accuracy and completeness
• Audit documentation to ensure files are compliant and audit-ready
• Verify authorizations, approvals, therapy changes, and operational documentation align correctly
• Review provider and pharmacist progress notes to ensure therapy interventions are properly supported
• Investigate discrepancies across multiple systems and portals
• Validate approved services and assist with accurate patient co-pay quoting
• Identify missing documentation, inconsistencies, or operational gaps that could lead to denials
• Collaborate cross-functionally with operational, insurance, pharmacy, and QC teams
• Maintain strong attention to detail while managing high-volume documentation review workflows

Qualifications

• Experience in specialty pharmacy, infusion pharmacy, healthcare operations, or medical insurance workflows preferred
• Knowledge of prior authorizations, benefits verification, medical benefits, or reimbursement processes strongly preferred
• Strong critical thinking and problem-solving skills
• Ability to work independently in a fast-paced, detail-oriented environment
• Comfortable reviewing large amounts of documentation across multiple systems
• Strong organizational and communication skills
• High attention to detail and auditing mindset

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients