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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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What cities are hiring for Full Time Qnxt jobs?

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 September 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Quality Control Reviewer III

Manhattan, NY • On-site

1199 Seiu National Benefit Fund
See more jobs at 1199 Seiu National Benefit Fundexternal

$50K - $64K/yr

Full-time

Medical

Re-posted 24 days ago

Job description

Requisition #:
7494
# of openings:
1
Employment Type:
Full time
Position Status:
Permanent
Category:
Bargaining
Workplace Arrangement:
Hybrid
Fund:
1199SEIU National Benefit Fund
Job Classification:
Non-Exempt
Responsibilities:
• Conduct audits of Provider Relations call center inquiries via various systems (i.e. Vitech, QNXT, and Call Tracking)
• Communicate with providers, collection agencies, hospitals, doctors, dentists, lawyers, employers, and other professionals regarding health claims and other benefit inquiries; provide backup coverage to Telephone Representatives as needed
• Assist Supervisor in reviewing work of call center staff and redistribute errors; provides departmental training and side-by-side mentoring of staff
• Assist Telephone Representatives with difficult calls and resolve complex problems
• Investigate issues, provider advances and assist providers with claim payments or adjustments
• Work closely with various departments, insurance carriers and other agencies to resolve issues (i.e. Provider Relations, Claims, Finance, Eligibility and Coordination of Benefits)
• Review eligibility and claims systems for errors and call track and/or escalate inquiries for corrections or adjustments
• Review and monitor department call tracking folder, process call tracking inquiries, identify trends and troubleshoot problems
• Access web-based or report applications relevant to provider inquiries (i.e. ABF, iObserver, intranet, on-demand reports, or external provider websites)
• Review and search information using knowledge tool (i.e. BeneFAQs)
• Must meet departmental performance standards
• 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 call center experience as a Telephone Representative in a health plan or benefits environment required
• Comprehensive knowledge of eligibility, rules for extended or limited continuation of benefits (coordination of benefits, retiree extensions, enrollment)
• Comprehensive knowledge of health benefits such as: hospital, surgical, x-ray, laboratory, major medical, etc.
• Knowledge of 1199SEIU Fund benefits preferred (National Benefit Fund, Greater New York and Home Care Fund)
• Experience navigating web based applications and Call Tracking Systems (Vitech, QNXT, iObserver and IRIS)
• Excellent communication skills (written and verbal) and interpersonal skills; ability to maintain a pleasant attitude with providers to ensure customer satisfaction
• Able to work well under pressure, multi-task, establish priorities, meet deadlines, and follow up
• Strong ability to lead, mentor and motivate others, maintain professional manner and presentation
• Good problem solver and excellent analytical skills
• Call Center hours of operation are from 8:00 am until 6:00 pm; shifts are subject to change and/or availability
• Must meet attendance and punctuality standards

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