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Qnxt Claims Processing Jobs (NOW HIRING)

1199SEIU Funds

Chief Clerk III

Manhattan, NY · On-site

Maintain accurate data entry of 199SEIU member information in hospital claims processing system (QNXT) Track and ensure completeness of daily inquires; ensure they are sent to appropriate payment ...

CEDENT

QNXT Configuration Architect

$40 - $60/hr

... Claim Processing, Billing, Plan/Product. • Experience with Healthcare domain. • Strong ... claims and how that goes into product and benefit configuration Compensation Hourly Rate Range ...

1199SEIU Funds

Telephone Representative II

Manhattan, NY · On-site

$17 - $22/hr

... claims processing systems (QNXT, Syntonics, V3) and Fund eligibility requirements preferred (1199SEIU National Benefit Fund, Greater New York Fund, Greater New Jersey Fund, Home Care Fund, Home ...

1199SEIU Funds

Telephone Representative II

Manhattan, NY · On-site

$17 - $22/hr

... claims processing systems (QNXT, Syntonics, V3) and Fund eligibility requirements preferred (1199SEIU National Benefit Fund, Greater New York Fund, Greater New Jersey Fund, Home Care Fund, Home ...

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How much do qnxt claims processing jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for qnxt claims processing in the United States is $19.16, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 per hour, depending on experience, location, and employer.

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.

What are the key skills and qualifications needed to thrive as a QNXT Claims Processor, and why are they important?

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 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.
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Qnxt Claims Processing jobs near you
Chief Clerk III

Chief Clerk III

1199SEIU Funds

Manhattan, NY • On-site

Full-time

Posted 10 days ago

Job description

Responsibilities:
Maintain accurate data entry of 199SEIU member information in hospital claims processing system (QNXT)
Track and ensure completeness of daily inquires; ensure they are sent to appropriate payment area for adjustment including but not limited to DMS (Data Management System)
Prepare MSP (Medicare Secondary Payer) claims/rebuttals, scan and archive supporting documents
Scan and archive documents into DMS (Data Management System)
Mail and maintain reconsideration letters including maintaining of acknowledgement of reconsideration letters
Track misdirected provider inquiries received from internal departments within the Fund, enter memo into QNXT and upload document to DMS (Data Management System)
Handle claim pending with edits for preparation of external transmission files, including review of aged edit(s), retrieval, and assignment of determination of incoming transmission files, follow up, sort and data entry of transmission files related information as needed
Review and maintain daily utilization management of claims and/or documents to ensure information is accurate and loaded in the claims system are correct, including updating memos and internal tracking logs with determination
Maintain monthly invoice report to ensure information is accurate and determinations loaded into claims processing system are correct; including updating memos of provider inquiries and medical records received, revised DRG received as well as claims processing/payment information; update internal spreadsheet tracker with claim determination
Communicate and follow up with external provider and/or vendor via telephone and/or email
Provide clerical support to the Hospital Claims department including but not limited to handling of mail filing, typing, photocopying, faxing, deliveries, etc.
Perform additional duties and special projects assigned by management

Qualifications:
High School Diploma or GED required, some College or Degree preferred
Minimum two (2) years clerical experience in a general office environment required
Basic skill level in Microsoft Excel and Word preferred
Excellent date entry skills required
Knowledge of hospital claims system (QNXT) and ability to check hospital claims history and eligibility
Excellent oral and written communication skills
Demonstrated organizational skills with ability to multi-task and follow up
Problem solver with ability to work independently and as a team player

Employment Type: Full time

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