- TEKsystems (Honolulu, HI)
- High-Level QNXT Developer Fully Remote, MUST WORK ON HAWAII TIME ZONE Monday to Friday, Full-Time | Contract | Description The client's Cotiviti project focuses on ... claims and payment integrity, and Cotiviti will integrate with QNXT . The third vendor to implement Cotiviti, but the...SQL, and it is highly preferred that they have QNXT experience. Claims will be sent to the Cotiviti… more
- Cognizant (Plano, TX)
- **Sr. QNXT Config Analyst.** **About the role:** As a Sr. QNXT Config Analyst, you will make an impact by conducting requirements using QNXT configuration. ... add PBPs. + Troubleshoot and remediate/workaround for claim pending issues. + QNXT Configuration for different State implementation. + Ability to do back-end queries… more
- Cognizant (Plano, TX)
- **About the role** As a QNXT Config Analyst, you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... to add PBPs. + Troubleshoot and remediate/workaround for claim pend issues. + QNXT Configuration for different State implementation + Ability to do back-end queries… more
- Cognizant (Plano, TX)
- **About the role:** As a Sr. QNXT Config Analyst, you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... add PBPs. . Troubleshoot and remediate/workaround for claim pending issues. . QNXT Configuration for different State implementation. . Ability to do back-end queries… more
- TEKsystems (Honolulu, HI)
- TEKsystems is seeking a strong QNXT .NET Developer for our local healthcare client in Hawaii Responsibilities: * Design, develop, and test applications using the ... QNXT Framework. * Implement and configure QNXT claims workflow, with a strong understanding of commercial and Medicare aspects. * Write and optimize SQL queries… more
- Cognizant (Bismarck, ND)
- …world. Together, we're improving everyday life. **Job Title** **: Sr QNXT Config Analyst** **Location** **:** **Remote** **Job ID** **: SO# 00062828461** ... reimbursement. . Troubleshoot and remediate/workaround for claim pend issues. . QNXT Configuration for New implementation and existing plan maintenance. . Ability… more
- Molina Healthcare (NM)
- …and/or Commercial experience + Strong SQL skills + Understanding of the QNXT Schema **Job Summary** Manages a team of professional Configuration Analysts. ... + Coding certification preferred + Knowledge of configuration in QNXT strongly preferred **JOB QUALIFICATIONS** **Required Education:** Bachelor's Degree or… more
- Molina Healthcare (Sioux City, IA)
- …implementation and conversion of new and existing health plans. + Must have QNXT configuration experience specifically in Benefits + Must have experience with SQL. ... **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination of education and experience **Required Experience** 5-7 years **Preferred Education** Graduate Degree or equivalent experience **Preferred Experience** 7-9 years To all… more
- Molina Healthcare (IA)
- …and claim processing from receipt through encounter submission + Strong Knowledge in QNXT required + Knowledge of Edifecs strongly preferred + Strong SQL knowledge ... required + Ability to write complex queries for impact analysis + Writes complex ad-hoc reports + Understanding of Healthcare EDI Claims transactions preferred + Understanding of complex claim payment methodologies + Understanding of configuration solutions… more
- LA Care Health Plan (Los Angeles, CA)
- …streamlining workflow processes, and preparing for the rollout of our new QNXT system. The duties completed will assist and provide invaluable information with ... completed for this task as a part of the QNXT time study project. 2. Records Request Management *...completed for this task as a part of the QNXT time study project. 3. Process Improvement Collaboration *… more
- Fallon Health (Worcester, MA)
- …territory. Update provider demographic and non contractual changes in QNXT /eVips accurately and timely. **Responsibilities** **Primary Job Responsibilities:** + ... internal resources in order to analyze and resolve issues. + Monitor status of QNXT cases thru to resolution status. Maintain detailed documentation within QNXT … more
- CVS Health (Salt Lake City, UT)
- …ongoing content delivery and maintenance across Medicaid claim editing vendors on QNXT , including supporting the Claim Editing Content Management and Claim Editing ... ClaimsXten for all Medicaid health plans). Also responsible for Medicaid PPM QNXT Claim Editing QA Process (Post Implementation Validation via Daily Edit… more
- Fallon Health (Worcester, MA)
- …of the TruCare documentation system as well as Fallon Health's core system QNXT + In coordination with the Administrative Assistant, manages the supplies inventory ... in Outlook and communicates such to interdepartmental teams via QNXT Call Tracking + Receives requests for ACO member...approved materials and communicates such to interdepartmental teams via QNXT Call Tracking + Utilizes Smart Data for processing… more
- Fallon Health (Worcester, MA)
- …utilizing NextGen ensuring that charts are current * Entering authorizations using QNXT * Scan all medical records from current and previous providers accurately ... * Excellent Customer service skills required **Resources:** MS Office Suite; QNXT ; NextGen **Fallon Health provides equal employment opportunities to all employees… more
- TEKsystems (Honolulu, HI)
- …operations. Thorough understanding and experience with Claims systems and QNXT . System Implementation: Integrate Cotiviti effectively, track testing, and ability ... medicare enrollment, vendor management, claims systems, management, healthcare operations, qnxt Top Skills Details healthcare insurance,medicare,medicare claims,medicaid programs,medicare enrollment,vendor… more
- Aston Carter (Honolulu, HI)
- …code maintenance/matching, maintaining enrollment segment accuracy between PBM system and QNXT . The Senior Enrollment Manager is responsible for training and ... enrollment data and accuracy of transmission to multiple systems (such as QNXT , PBM, 4Rx, CMS and any enrollment intermediary). Responsible for process improvement… more
- Fallon Health (Worcester, MA)
- …management. * Provides support in auditing provider linking to contract logic in QNXT ; completing 10 records monthly to maintain provider linking knowledge. * May ... Knowledge of provider data/enrollment. Experience in the symplr Payer (eVIPs) and QNXT systems is preferred but not required. **Fallon Health provides equal… more
- Fallon Health (Worcester, MA)
- …Partners in the testing phases + Responsible for all testing of Edifecs and QNXT system upgrades or changes as they relate to electronic submission + Accountable for ... of a Managed Care Organization or 2+ years of experience with preferred degree. + QNXT experience a must. + Extremely PC savvy. + Strong knowledge of MS Office… more
- CVS Health (Richmond, VA)
- …information for approval of medical authorizations. - Uses Aetna Systems such as QNXT , ProFAX, ProPAT, and Milliman Criteria. - Communicates with Aetna Nurses and ... Medical Directors, when processing transactions for members active in this Program. - Sedentary work involving significant periods of sitting, talking, hearing and keying. - Work requires visual acuity to perform close inspection of written and computer… more
- Commonwealth Care Alliance (Boston, MA)
- …Desired Experience (nice to have): * Experience with core claims platforms - Facets, QNXT , or Amisys * MS, HTML, other software and tools Required Knowledge, Skills ... & Abilities (must have): * Strong analytical skills and familiarity with common data analytics tools, including Excel, Access, SQL, Tableau or other analytical tools * Knowledge and experience of claim operations, health care reimbursement, public health care… more
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