QNXT Claim Analyst

Veriipro; Hartford (CT); On-site; USD 60,000 - 80,000; Full time

Job summary

Veriipro is looking for a skilled professional in Hartford, Connecticut to manage Medicaid Claims Adjudication on the QNXT platform. The ideal candidate will have expertise in Medicaid EDI 837 Claims, contract knowledge with US Healthcare providers, and experience in software testing methodologies.

The position requires strong capabilities in executing Medicaid CXT Claim Edits and understanding various healthcare plans. Familiarity with tools like JIRA and Rational Tool Suite is essential for success in this role.

Qualifications

• Expertise in Medicaid Claims Adjudication in QNXT platform.
• Experience in Manual Automation Testing planning execution.
• Strong understanding of Software Testing methodologies.

Responsibilities

• Perform Medicaid Claims Adjudication in QNXT platform.
• Execute Medicaid CXT Claim Edits with expertise.
• Utilize knowledge on US Healthcare Provider Plans.

Skills

Medicaid EDI 837 Claims Adjudication Expertise

US Healthcare Provider Contracting Expertise

SQL queries

Tools

JIRA

Rational Tool suite

Job description

Skills :

• Medicaid EDI 837 Claims Adjudication Expertise in QNXT with CXT Edits.
• US Healthcare Provider Contracting and Demographics Expertise.
• Medicaid Healthcare Plans Configuration for Claims Processing
• Knowledge on SQL queries

Responsibilties :

• Medicaid Claims Adjudication in QNXT Platform.
• Medicaid CXT Claim Edits Hands on Expertise
• Knowledge on US Healthcare Provider Plans and different Classifications/Specialties
• Experience in Manual Automation Testing planning execution
• Strong understanding of Software Testing methodologies.
• Experience with Test Management tools Rational Tool suite, JIRA.