QNXT Claims Analyst

Veriipro; Hartford (CT); On-site; USD 80,000 - 110,000; Full time

Job summary

Veriipro is seeking a skilled professional in Hartford, Connecticut, for Medicaid Claims Adjudication. The ideal candidate should have at least 6 years of experience, particularly with the QNXT platform and Medicaid claims processes.

Critical skills include expertise in Medicaid EDI 837 Claims Adjudication, SQL knowledge, and familiarity with Test Management tools such as JIRA. Strong communication skills and experience in Software Testing methodologies are essential for this role.

Qualifications

• Minimum 6 years of experience in Medicaid Claims Adjudication.
• Expertise in Manual Automation Testing planning and execution.
• Strong understanding of Software Testing methodologies.

Responsibilities

• Adjudicate Medicaid Claims in the QNXT Platform.
• Implement Medicaid CXT Claim Edits.
• Prepare Test Plans, Test Scripts, and Test Results.

Skills

Medicaid EDI 837 Claims Adjudication

QNXT with CXT Edits

US Healthcare Provider Contracting

SQL knowledge

Tools

JIRA

Rational Tool suite

Job description

Minimum years of experience required: 6+ years Certification needed: Not mandatory

Must Have 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.

Detailed Job Description

1. Medicaid Claims Adjudication in QNXT Platform.
2. Medicaid CXT Claim Edits Hands on Expertise.
3. Knowledge on US Healthcare Provider Plans and different Classifications/Specialties.
4. Experience in Manual Automation Testing planning execution.
5. Strong understanding of Software Testing methodologies.
6. Experience with Test Management tools Rational Tool suite, JIRA.
7. Working experience in Test Plan, Test Scripts and Test Result preparation, Status reporting.
8. Strong communication skills.
9. Knowledge on SQL queries.