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Qnxt Claims Processing Jobs in Hawaii (NOW HIRING)

3B Staffing LLC

QNXT Technical Architect

Honolulu, HI · Remote

$65.50 - $79/hr

QNXT Technical Architect Duration: 6+ months Location: Remote - Work Hawaiian standard time (HST ... Claims Processing * Enrollment * Benefits * Provider * Experience with web services, REST APIs ...

3B Staffing LLC

QNXT Technical Architect

Honolulu, HI · Remote

$65.50 - $79/hr

QNXT Technical Architect Duration: 6+ months Location: Remote - Work Hawaiian standard time (HST ... Claims Processing * Enrollment * Benefits * Provider * Experience with web services, REST APIs ...

HMSA

Medical Management Specialist I

Kapolei, HI · On-site

Processing of the Aerial to QNXT (A2Q) error / balance reports by: * Accurately building UMD documents within QNXT to support the claims processing activities. * Notify and/or communicate issues ...

All JobsQnxt Claims Processing JobsQnxt Claims Processing Jobs in Hawaii

Qnxt Claims Processing information

What is QNXT claims processing?

QNXT claims processing refers to the use of the QNXT software platform, developed by TriZetto, to automate and manage healthcare claims for insurance companies and healthcare providers. This system streamlines the claims lifecycle, from submission and validation to adjudication and payment. It helps organizations improve accuracy, reduce processing times, and ensure compliance with industry regulations. QNXT is widely used in the healthcare industry to increase operational efficiency and enhance member and provider satisfaction.

What are the key skills and qualifications needed to thrive as a QNXT claims processor?

To thrive as a QNXT Claims Processor, you need strong analytical skills, attention to detail, and a solid understanding of healthcare insurance claims, often supported by relevant experience or training. Proficiency in QNXT claims management software, knowledge of ICD-10, CPT coding, and familiarity with HIPAA regulations are typically required. Excellent communication, organizational abilities, and problem-solving skills help you manage claim inquiries and resolve discrepancies effectively. These skills ensure accurate claims adjudication, timely processing, and compliance with regulatory standards, which are vital for operational efficiency in healthcare organizations.

What are some common challenges faced in a QNXT claims processing role, and how can they be effectively managed?

Professionals in Qnxt Claims Processing often encounter challenges such as navigating complex insurance policies, resolving discrepancies in claim data, and meeting tight deadlines while maintaining a high level of accuracy. Effective management of these challenges involves a strong attention to detail, familiarity with Qnxt software functionalities, and clear communication with both internal teams and external providers. Additionally, staying updated on regulatory changes and participating in ongoing training can help streamline processes and reduce errors, making the work more efficient and less stressful.

What is the difference between Qnxt Claims Processing vs Claims Analyst?

AspectQnxt Claims ProcessingClaims Analyst
CertificationsHealthcare IT, Claims Processing CertificationsClaims Processing, Healthcare Billing Certifications
Work EnvironmentHealthcare insurance companies, third-party administratorsInsurance companies, healthcare providers, third-party payers
Job FocusManaging and processing claims using Qnxt softwareAnalyzing claims data, resolving discrepancies, ensuring accuracy

Qnxt Claims Processing specialists primarily focus on managing claims through the Qnxt platform, ensuring efficient processing and compliance. Claims Analysts, on the other hand, analyze claims data, identify issues, and resolve discrepancies. While both roles require knowledge of healthcare claims and certifications, Qnxt Claims Processing roles are more technical and software-specific, whereas Claims Analysts focus on data analysis and problem-solving within the claims process.

Is Qnxt Claims Processing a stressful job?

Qnxt Claims Processing roles can be stressful due to the high volume of claims and strict deadlines. The job requires attention to detail, accuracy, and familiarity with claims management software, which can contribute to work pressure, especially during busy periods.

What are popular job titles related to Qnxt Claims Processing jobs in Hawaii?

For Qnxt Claims Processing jobs in Hawaii, the most frequently searched job titles are:

What job categories do people searching Qnxt Claims Processing jobs in Hawaii look for?

The top searched job categories for Qnxt Claims Processing jobs in Hawaii are:

What cities in Hawaii are hiring for Qnxt Claims Processing jobs?

Cities in Hawaii with the most Qnxt Claims Processing job openings:

Qnxt Claims Processing jobs near you
Infographic showing various Qnxt Claims Processing job openings in Hawaii as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution.

QNXT Technical Architect

3B Staffing LLC

Honolulu, HI • Remote

$65.50 - $79/hr

Full-time

Posted 12 days ago

Job description

Role: QNXT Technical Architect

Duration: 6+ months

Location: Remote - Work Hawaiian standard time (HST)

QNXT Technical Architect to lead the design, development, integration, and optimization of the QNXT platform. The ideal candidate will have extensive experience with QNXT architecture, healthcare payer systems, and enterprise application integration. This role requires strong technical leadership, solution design expertise, and the ability to collaborate with business and technology stakeholders to deliver scalable healthcare solutions.

Key Responsibilities

  • Design, architect, and implement enterprise solutions using the QNXT platform.
  • Lead technical architecture discussions and establish best practices for QNXT implementations.
  • Design and develop custom extensions, interfaces, APIs, and integrations with internal and third-party systems.
  • Collaborate with business analysts, developers, infrastructure teams, and business stakeholders to translate business requirements into technical solutions.
  • Provide technical leadership for QNXT upgrades, enhancements, and modernization initiatives.
  • Develop integration solutions using REST APIs, SOAP services, ETL processes, and middleware technologies.
  • Ensure system scalability, security, performance, and compliance with healthcare regulations.
  • Troubleshoot complex production issues and provide root cause analysis.
  • Lead code reviews, architecture reviews, and technical governance activities.
  • Mentor developers and technical team members on QNXT best practices.
  • Support DevOps, CI/CD, and cloud migration initiatives where applicable.
  • Create technical design documents, architecture diagrams, and implementation standards.

Required

  • 8+ years of IT experience with at least 3+ years working on QNXT.
  • 3+ years of experience in a Technical Architect or Solution Architect role.
  • Strong understanding of QNXT database architecture and application components.
  • Experience with SQL Server, T-SQL, performance tuning, and database optimization.
  • Strong knowledge of healthcare payer operations, including:
    • Claims Processing
    • Enrollment
    • Benefits
    • Provider
  • Experience with web services, REST APIs, SOAP, XML, JSON, and integration frameworks.
  • Knowledge of Azure or AWS cloud platforms is preferred.

Apply