Position Overview
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
Position Overview
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
*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
