... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
... claims processing, SQL, and end-to-end testing. Roles and Responsibilities * Configure and maintain ... Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
Qnxt Claims Processing information
See salary details
$12.02 - $13.33
2% of jobs
$13.33 - $14.64
6% of jobs
$14.64 - $15.95
9% of jobs
$16.63 is the 25th percentile. Wages below this are outliers.
$15.95 - $17.26
14% of jobs
$17.26 - $18.58
18% of jobs
The median wage is $18.62 / hr.
$18.58 - $19.89
17% of jobs
$20.61 is the 75th percentile. Wages above this are outliers.
$19.89 - $21.20
16% of jobs
$21.20 - $22.51
7% of jobs
$22.51 - $23.82
4% of jobs
$23.82 - $25.13
4% of jobs
$25.13 - $26.44
2% of jobs
$12
$19
$26
How much do qnxt claims processing jobs pay per hour?
As of Aug 14, 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?
| Aspect | Qnxt Claims Processing | Claims Analyst |
|---|---|---|
| Certifications | Healthcare IT, Claims Processing Certifications | Claims Processing, Healthcare Billing Certifications |
| Work Environment | Healthcare insurance companies, third-party administrators | Insurance companies, healthcare providers, third-party payers |
| Job Focus | Managing and processing claims using Qnxt software | Analyzing 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?
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.
Is claims processing a stressful job?
Qnxt Claims Processing involves reviewing and managing insurance claims, which can be stressful due to tight deadlines, high accuracy requirements, and the need to handle complex or disputed claims. The job often requires attention to detail, familiarity with claims processing software, and the ability to work efficiently under pressure.
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.
More about Qnxt Claims Processing jobs
What cities are hiring for Qnxt Claims Processing jobs?
Cities with the most Qnxt Claims Processing job openings:
What states have the most Qnxt Claims Processing jobs?
States with the most job openings for Qnxt Claims Processing jobs include:
What job categories do people searching Qnxt Claims Processing jobs look for?
The top searched job categories for Qnxt Claims Processing jobs are:
Full-time
Medical
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Job description
Position Overview
We are seeking an experienced QNXT Benefit Configuration Analyst to support the implementation, enhancement, and maintenance of benefit plans within the TriZetto QNXT platform. The ideal candidate will have extensive experience configuring commercial and/or government healthcare products, translating business requirements into system configurations, and collaborating with cross-functional teams to deliver high-quality healthcare solutions.
The candidate should possess strong knowledge of healthcare payer operations, benefit plan design, claims processing, SQL, and end-to-end testing.
Roles and Responsibilities- Configure and maintain benefit plans within the QNXT platform based on business and regulatory requirements.
- Configure Service Groups, Restriction Groups, Copay Groups, Coinsurance, Deductibles, Out-of-Pocket Maximums (MOOP), Accumulators, Visit Limits, Authorization Rules, and Benefit Limits.
- Configure benefits for Commercial, Medicare Advantage, Medicaid, Exchange, PPO, HMO, POS, EPO, and ASO products.
- Analyze business requirements and translate them into detailed configuration specifications.
- Collaborate with Business Analysts, Product Owners, Configuration Analysts, Developers, QA, and Business Stakeholders.
- Perform impact analysis for new benefit changes, regulatory updates, and annual benefit plan implementations.
- Support annual benefit rollovers and Open Enrollment implementations.
- Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly.
- Develop configuration documentation, design documents, mapping documents, and implementation guides.
- Troubleshoot benefit configuration issues and identify root causes.
- Support production incidents and resolve benefit configuration defects.
- Participate in requirements gathering sessions, JAD sessions, backlog grooming, sprint planning, and release planning.
- Work closely with QA teams during SIT, UAT, and regression testing.
- Perform SQL queries to validate configuration data, troubleshoot issues, and analyze claim outcomes.
- Participate in release deployments and post-production validation activities.
- Collaborate with downstream teams supporting Claims, Enrollment, Provider, Finance, EDI, and Customer Service.
- Maintain configuration version control using QCS, CMT, or other migration tools.
- Ensure compliance with CMS, State Medicaid, and Commercial regulatory requirements.
- 5+ years of Healthcare Payer experience.
- 5+ years of hands-on TriZetto QNXT Benefit Configuration experience.
- Strong understanding of healthcare benefit design and claims adjudication.
- Experience configuring:
- Service Groups
- Restriction Groups
- Copay Groups
- Coinsurance
- Deductibles
- Accumulators
- MOOP
- Visit Limits
- Prior Authorization Rules
- In-Network / Out-of-Network Benefits
- Experience with Commercial, Medicare, and Medicaid benefit plans.
- Strong SQL skills including:
- Experience troubleshooting claims adjudication issues.
- Experience validating benefit configurations using test claims.
- Ability to read and interpret business requirements and technical documentation.
- Strong analytical and problem-solving skills.
- Excellent communication and stakeholder management skills.
- Experience with QCS (QNXT Configuration Studio).
- Experience with CMT (Configuration Migration Tool).
- Experience supporting annual benefit implementations.
- Experience with Medicare Advantage and Medicaid Managed Care plans.
- Experience with CMS regulations.
- Experience working in Agile/Scrum environments.
- Experience using Jira, Azure DevOps, or Rally.
- Experience supporting large healthcare payer organizations.
About Techvilla Solutions
Sourced by ZipRecruiter
Industry
It services
Company size
51 - 200 Employees
Headquarters location
CA, US
Year founded
2006