QAB Specialist

ProCare Pharmacy Benefit Manager, Inc.; Gainesville (GA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health benefits

Paid vacation

Wellness program

401(k) with match

Employee assistance program

Referral program

Job summary

ProCare Rx is seeking a Quality Assurance Business Specialist to audit new plan/group implementations and test modifications to existing plans. The role involves generating reports, validating plan setups, and coordinating with multiple departments to ensure accuracy and timely updates.

The ideal candidate will be a certified Pharmacy Technician with experience in quality control, process testing, and precise documentation.

Qualifications

• Audit new plan/group implementations for accuracy and completeness.
• Test modifications to existing plans/groups and document results.
• Prepare reports to validate plan setups and ensure billing reversals.
• Communicate findings across departments to implement changes.
• Proofread and review materials for consistency and clarity.

Responsibilities

• Execute QAB-related tasks and processes in the QAB department.
• Run weekly reports to validate plan flags are set appropriately.
• Run billing reports to validate test claims reversed before billing cycle.
• Write reports producing accurate information to validate plan setups.
• Review materials to ensure client requests are satisfied and updates are correct.
• Document testing procedures for new functionality and present insights.

Skills

Quality Control

Test reporting

System testing

Proactive communication

Excel

Google Sheets

Documentation

Education

Certified Pharmacy Technician

Tools

R&R Reports Works

Job description

Job Category: Benefit/Formulary Imp. & Quality Assurance

Requisition Number: QASPE001728

• Posted : July 22, 2026
• Full-Time
• On-site

Locations

Showing 1 location

1267 Professional Pkwy
Gainesville, GA 30507, USA

1267 Professional Pkwy
Gainesville, GA 30507, USA

The Quality Assurance Business Specialist (QAB) 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 QAB-related tasks and processes in the QAB 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
• 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 Calender skills a plus.
• Knowledge of R&R Reports Works a plus.

Physical Demands

• Requires sitting, standing, and occasional light lifting.

The Perks of Joining Our Team:

We believe in taking care of our team. You'll enjoy a comprehensive benefits package designed to support your well-being and financial future:

• Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
• Time to Recharge: Paid vacation and holiday pay.
• Focus on Your Wellness: We offer a robust Employee Wellness Program.
• Invest in Your Future: 401(k) with a company match.
• Support System: Employee Assistance Program provides confidential support and counseling.
• Get Rewarded for Referring Great People: Employee referral program.

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 [e-mail].

ProCare Rx is an Equal Opportunity Employer

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.

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