Remote QA Engineer - Pharmacy Benefits & Claims

Southern Scripts; Dallas (TX); Remote; USD 85,000 - 120,000; Full time

Benefits offered by this job

Medical, Dental and Vision insurance

Disability and Life insurance

Employee Assistance Program

Remote work options

Generous Paid-Time Off

Retirement Plan with company match

Job summary

Liviniti, LLC is seeking a Manual QA Engineer to safeguard accuracy and quality of its pharmacy benefit technology. You will design and execute manual tests across claims adjudication, pricing, and benefit configurations, ensure fixes meet expectations, and partner with analysts and developers throughout releases.

You will validate edge cases like copays and DUR, maintain test docs, and support stage cycles for release sign-off.

Qualifications

• 3-5 years of manual QA testing experience within a PBM, health plan, or pharmacy claims environment.
• Hands-on experience testing claims adjudication systems and pharmacy benefit configurations.
• Working knowledge of pharmacy claims concepts: NCPDP claim formats, formulary/tiering, copay/coinsurance logic, accumulators, DUR, prior authorization, and rebates.
• Strong ability to write clear, structured test cases and defect reports.
• Experience with test case management and defect tracking tools (Azure DevOps, Jira, TestRail, or similar).
• Solid understanding of the software QA lifecycle (test planning, execution, regression, UAT).
• Excellent attention to detail and ability to spot discrepancies in complex rule-based systems.
• Strong written and verbal communication skills for cross-functional collaboration

Responsibilities

• Design, write, and execute manual test cases and test plans covering claims adjudication, pricing, formulary, accumulators, prior authorization, and benefit plan configuration.
• Validate claim outcomes (paid, rejected, reversed) against expected adjudication logic and plan setup.
• Perform regression, functional, and end-to-end testing across releases and configuration changes.
• Identify, document, and track defects with clear 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 involving copay structures, DUR, accumulator resets, 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

Manual testing

PBM knowledge

SQL querying

Test case writing

Documentation

Communication

QA lifecycle

Attention to detail

Tools

Azure DevOps

Jira

TestRail

Job description

Liviniti, LLC is seeking a Manual QA Engineer to safeguard accuracy and quality of its pharmacy benefit technology. You will design and execute manual tests across claims adjudication, pricing, and benefit configurations, ensure fixes meet expectations, and partner with analysts and developers throughout releases.

You will validate edge cases like copays and DUR, maintain test docs, and support stage cycles for release sign-off.