Remote Manual QA Engineer - PBM Claims & Adjudication

Randstad Digital Americas; Natchitoches (LA); Remote; USD 80,000 - 110,000; Full time

Job summary

Randstad Digital Americas is seeking an experienced Manual QA Engineer to validate claims adjudication logic, benefit configurations, and system behavior across our PBM platform. The role is remote (telecommute) with a permanent contract and a salary range of $80,000 to $110,000 per year.

Working hours are 8am–5pm, and a Bachelor's degree is required. The ideal candidate will design and execute manual test cases, verify outcomes, perform regression and end-to-end testing, and collaborate with

Qualifications

• 3–5 years of manual QA testing experience in PBM/health plan/pharmacy claims environments
• Hands-on testing of claims adjudication systems and pharmacy benefit configurations
• Knowledge of pharmacy claims concepts: NCPDP formats, formulary/tiering, copay/coinsurance logic, accumulators, DUR, prior authorization, rebates
• Ability to write clear, structured test cases and defect reports
• Experience with test case management and defect tracking tools (Azure DevOps, Jira, TestRail) and QA lifecycle (test planning, execution, regression, UAT)

Responsibilities

• Design, write, and execute manual test cases and test plans for claims adjudication, pricing, formulary, accumulators, prior authorization, and benefit plan configuration
• Validate claim outcomes against adjudication logic and plan setup
• Perform regression, functional, and end-to-end testing across releases and configuration changes
• Identify, document, and track defects with reproduction steps, expected vs. actual behavior, and business impact
• Collaborate with business analysts, developers, and configuration teams to clarify requirements and validate fixes
• Test edge cases for copay structures, DUR, accumulators, coordination of benefits, and vendor integrations
• Maintain and update test documentation, test data sets, and traceability to requirements
• Participate in Stage cycles and support release sign-off decisions

Skills

Attention to detail

Written communication

Verbal communication

Cross-functional collaboration

Test planning

UAT understanding

Education

Bachelor's degree

Tools

Azure DevOps

Jira

TestRail

SQL

Job description

Randstad Digital Americas is seeking an experienced Manual QA Engineer to validate claims adjudication logic, benefit configurations, and system behavior across our PBM platform. The role is remote (telecommute) with a permanent contract and a salary range of $80,000 to $110,000 per year.

Working hours are 8am–5pm, and a Bachelor's degree is required. The ideal candidate will design and execute manual test cases, verify outcomes, perform regression and end-to-end testing, and collaborate with