Role & responsibilities

- 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:
- Member eligibility and benefit verification
- Pharmacy/provider validation (NPI, NCPDP ID)
- Real-time POS claims adjudication
- Pricing logic (AWP, MAC, ingredient cost, dispensing fee, copay, accumulators)
- Experience in testing scenarios involving:
- Coordination of Benefits (COB) / Other Payer

- Prior Authorization (PA)
- Formulary and benefit plan rules
- Specialty and retail pharmacy claims
- Understanding of NCPDP standards (D.0; exposure to F6 preferred)




- Ability to interpret business and technical requirements for testing Agile/Waterfall models
- Good communication skills to report test results and defects clearly
- Experience in web services/API testing using Postman or SoapUI
- Basic knowledge of automation tools and testing practices

Robust interpersonal skills and ability to work with cross-functional teams

Preferred candidate profile

PBM / Pharmacy Claim

4 to 9 Years

Chennai, Pune, Noida, Bengaluru, Coimbatore, Hyderabad, Mumbai

Immediate to 30 days NP if you are interested please share resume to [email protected]

📌 PBM / Pharmacy Claim DOmain (Chennai)
🏢 Hexaware Technologies
📍 Chennai