Minimum of 4+ years of QA experience with PBM / pharmacy claims domain knowledge • Experience in writing SQL queries for data validation • Ability to design and execute test cases, test scenarios, and test data • Hands-on experience in validating end-to-end pharmacy claims lifecycle, including: o Member eligibility and benefit verification o Pharmacy/provider validation (NPI, NCPDP ID) o Real-time POS claims adjudication o Pricing logic (AWP, MAC, ingredient cost, dispensing fee, copay, accumulators) • Experience in testing scenarios involving: o Coordination of Benefits (COB) / Other Payer o Prior Authorization (PA) o Formulary and benefit plan rules Same Posting Description for Internal and External Candidates (Provide boolean search for this role)