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Full Time Qnxt Jobs (NOW HIRING)

1199SEIU Funds

Hospital Claims Processor V

New York, NY · On-site

$45K - $57K/yr

Requisition #: 7513 # of openings: 1 Employment Type: Full time Position Status: Permanent Category ... Validate information entered in hospital claims module (QNXT); determine the process or work flow ...

1199SEIU Funds

Quality Control Reviewer II

New York, NY · On-site

$47K - $60K/yr

Requisition #: 7511 # of openings: 1 Employment Type: Full time Position Status: Permanent Category ... Non-Exempt Responsibilities • Monitor claims processing system (QNXT) to ensure functionality of ...

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Full Time Qnxt information

What is a full time QNXT?

A Full Time QNXT job typically refers to a position where an employee works with the QNXT software system, which is a healthcare payer core administration platform developed by TriZetto. Professionals in these roles may be responsible for configuring, maintaining, or supporting QNXT for health insurance companies, focusing on claims processing, member management, and provider data. Full-time QNXT jobs can include roles like QNXT Analysts, Developers, Business Analysts, and Support Specialists. These positions generally require knowledge of healthcare processes, experience with QNXT, and problem-solving skills. Working full-time means a standard workweek, often with benefits and long-term employment.

What are some common challenges faced by full time QNXT professionals when managing complex healthcare claims?

Full Time QNXT professionals often encounter challenges such as navigating intricate claims data, adapting to frequent regulatory updates, and ensuring data accuracy while processing high volumes of transactions. Collaboration with IT, clinical, and business teams is essential to resolve system issues and streamline workflows. To succeed, professionals must stay current with QNXT system enhancements and industry best practices, which helps ensure compliance and operational efficiency.

What are the key skills and qualifications needed to thrive as a full time QNXT analyst, and why are they important?

To thrive as a Full Time QNXT Analyst, you need a solid understanding of healthcare claims processing, benefit configuration, and experience with the QNXT platform, often supported by a degree in healthcare administration or a related field. Proficiency with QNXT software, SQL, and knowledge of related systems like EDI and HIPAA compliance is typically required. Strong problem-solving abilities, attention to detail, and effective communication are important soft skills in this role. These competencies ensure accurate claims processing, regulatory compliance, and collaboration across teams for efficient healthcare operations.

What is the difference between Full Time Qnxt vs Health Insurance Claims Processor?

AspectFull Time QnxtHealth Insurance Claims Processor
CredentialsTypically requires knowledge of Qnxt software, healthcare billing, and coding certificationsRequires understanding of insurance policies, billing, and coding, often with similar certifications
Work EnvironmentOffice-based, healthcare or insurance company settings, involving software use and data managementOffice or remote, handling claims data, customer interactions, and billing processing
Industry UsagePrimarily in healthcare administration, insurance companies, and third-party administratorsIn healthcare insurance companies, hospitals, and billing services

Full Time Qnxt roles focus on managing healthcare data using the Qnxt platform, requiring specific software knowledge and certifications. Health Insurance Claims Processors handle claims and billing, often with overlapping skills. Both roles are essential in healthcare administration but differ mainly in software specialization and daily tasks.

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Cities with the most Full Time Qnxt job openings:

What are the most commonly searched types of Qnxt jobs?

The most popular types of Qnxt jobs are:

What job categories do people searching Full Time Qnxt jobs look for?

The top searched job categories for Full Time Qnxt jobs are:

Full Time Qnxt jobs near you
Infographic showing various Full Time Qnxt job openings in the United States as of August 2026, with employment types broken down into 84% Full Time, and 16% Contract. Highlights an 50% Physical, 2% Hybrid, and 48% Remote job distribution.

Telephone Representative II (Provider Relations)

1199 Seiu National Benefit Fund

Manhattan, NY • On-site

$49K - $62K/yr

Full-time

Medical, Dental, Vision

Re-posted 20 days ago

Job description

Requisition #:
7479-7485
# of openings:
7
Employment Type:
Full time
Position Status:
Permanent
Category:
Bargaining
Workplace Arrangement:
Hybrid
Fund:
1199SEIU National Benefit Fund
Job Classification:
Non-Exempt
Responsibilities
  • Communicate with doctors, hospitals, and other professionals via telephone regarding 1199SEIU members, dependent eligibility for health benefits, claims, and other plan services
  • Verify and determine eligibility for members, spouses, dependents, including the reinstatement of terminated coverage
  • Research and request documentation for provider enrollment, credentialing and provider file updates
  • Research and provide schedule of allowance for procedure codes and prior authorization requirements, research check reconciliation of claim payments
  • Accurately and professionally respond to telephone inquiries regarding member benefits and claims
  • Examine dental, vision, hospital, and medical claim histories for claim status, accuracy and timeliness
  • Create call tracking records in call tracking system (QNXT) to the appropriate call tracking folders for resolution; mail printed materials upon request
  • Review call tracking items returned to individual folder for closure or assignment to correct call tracking folder as required
  • Assign claim inquiries, enrollment, and eligibility issues to appropriate call tracking folders for resolution
  • Generate call tracking inquiries for problems related to all of the above for correction
  • Advise providers of new programs, plan improvements and plan changes
  • Verify provider inquiry using Knowledge Tool (BeneFAQs, QNXT, DocFind, iObserver)
  • Retrieve and review scanned claim images using IRIS System
  • Perform additional duties and projects as assigned by management

Qualifications
  • High School Diploma or GED required; Some College or Degree preferred
  • Minimum two (2) years high volume customer service experience in a call center environment; or two (2) years health claims processing experience required
  • Excellent Keyboarding Skills Required.
  • Experience using web-based applications, basic knowledge of health claims processing systems (QNXT, Vitech) and Fund eligibility requirements preferred (National Benefit Fund, Greater New York Fund, Home Care Fund); experience with Provider Relations a plus
  • Excellent written and verbal communication skills with great interpersonal skills
  • Ability to initiate own correspondence and maintain a pleasant attitude to ensure excellent service to members and providers
  • Ability to multi-task and work under pressure due to volume and urgent nature of calls
  • Call Center hours of operation are from 8:00 am - 6:00 pm; shifts are subject to change and/or availability

Apply