JOB TITLE: Product Support / QA Specialist
EMPLOYER: AssistRx
DEPARTMENT: Product Support
REPORTS TO: Product Manager, Product Support
EFFECTIVE DATE: 3/24/2022
SUMMARY: We are seeking a highly detail-oriented and self-motivated individual to join our team as a Product Support/QA Specialist. In this role, you will use proprietary tools to build, test, and maintain a comprehensive library of electronic prior authorization (ePA) forms, as well as maintaining the company’s comprehensive asset library encompassing a wide range of correspondence materials. This position plays a critical role in ensuring the accuracy and quality of our product offerings and supports the continued growth of our solutions portfolio. Success in this role requires the ability to work independently, conduct in-depth research, and demonstrate exceptional attention to detail and follow-through.
DUTIES AND RESPONSIBILITIES:
- Conduct comprehensive research using electronic sources, such as databases and online repositories, to identify and validate prior authorization (PA) forms for all relevant products.
- Build and maintain digital assets, including electronic prior authorization (ePA) forms and various correspondence materials, using internal proprietary systems.
- Test system modifications and new functionality to ensure accuracy and readiness for implementation; document and report software defects to developers or relevant departments.
- Participate in product design and development discussions, providing detailed input on functional requirements, usability, and potential risk areas.
- Analyze payer-provided content to create cohesive and compliant question sets, ensuring alignment with clinical and regulatory standards.
- Utilize basic clinical knowledge to correctly associate PA forms with appropriate products, therapeutic areas, and use cases.
- Create, edit, and maintain PDFs using Adobe Acrobat DC Pro to ensure proper formatting, accessibility, and compliance.
- Adhere to all applicable data privacy, security, and compliance standards, including HIPAA and internal data governance policies.
- Work independently to manage assigned tasks, meet deadlines, and maintain a high standard of quality across all deliverables.
- Support continuous improvement initiatives by identifying opportunities for increased efficiency, accuracy, and automation in form development and quality assurance processes.
SUPERVISORY RESPONSIBILITIES:
- This job has no supervisory responsibilities.
Minimum Qualifications:
- Solid understanding of prescription drug reimbursement processes, including insurance plan types, major medical benefits, and prior authorization requirements.
- Basic knowledge of prescription drugs, including administration methods, routes, dosages, dosage forms, and common drug classifications.
- Proficient in the use of computers and software applications, including Microsoft Office Suite, Adobe Acrobat, web-based platforms, and general keyboarding skills.
- Ability to quickly adapt to new systems, workflows, and technologies, and learn company-specific policies and procedures effectively.
- Exceptional attention to detail with the ability to perform repetitive tasks with a high degree of accuracy and consistency.
- Strong written and verbal communication skills to document, explain, and collaborate on technical or process-related information clearly and professionally.
- Excellent interpersonal skills, with the ability to collaborate effectively across diverse teams and work with individuals from various backgrounds.
- Prior experience in Specialty Pharmacy or Managed Care, with a working knowledge of specialty medications and the associated prior authorization process.
Preferred Qualifications:
- Bachelor’s degree in healthcare, life sciences, pharmacy, health information management, or a related field.
- Previous experience working with electronic prior authorization (ePA) systems or pharmacy benefit management (PBM) platforms.
- Familiarity with industry-standard coding systems such as NDC, HCPCS, or ICD-10.
- Understanding of payer policies and utilization management criteria for specialty medications.
- Experience conducting quality assurance reviews and documenting process improvements.
- Proficiency with Adobe Acrobat DC Pro for creating and editing accessible, fillable PDFs.
- Demonstrated ability to manage multiple projects or tasks simultaneously while meeting tight deadlines.
- Experience in a remote or hybrid work environment with minimal supervision.
- Familiarity with HIPAA and other healthcare data privacy regulations.
- Knowledge of clinical terminology and medical benefit coverage criteria.
COMPETENCIES:
- Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
- Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
- Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
- Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
- Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
- Design - Generates creative solutions; Translates concepts and information into images; Uses feedback to modify designs; Applies design principles; Demonstrates attention to detail.
- Initiative - Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Takes independent actions and calculated risks; Looks for and takes advantage of opportunities; Asks for and offers help when needed.
- Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
- Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; Supports organization's goals and values; Benefits organization through outside activities; Supports affirmative action and respects diversity.
- Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans.
- Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
- Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
- Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
- Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
- Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
- Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
- Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
PHYSICAL DEMANDS AND WORK ENVIRONMENT:
- Occasionally required to stand.
- Occasionally required to walk.
- Continually required to sit.
- Continually required to utilize hand and finger dexterity.
- Frequently required to talk or hear.
- While performing the duties of this job, the noise level in the work environment is usually moderate
- Specific vision abilities required by this job include depth perception and ability to adjust focus.
- Additional remarks regarding work environment:
- Additional remarks regarding work environment:
- This job operates in a professional office environment.
- Standard office lighting.
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
ACKNOWLEDGEMENT
I have read the foregoing job description and understand the responsibilities of the job. I agree that I am able to perform the essential duties of this position.