Healthcare QNXT Configuration Analyst Consultant

posted on August 20, 2018

Job Description

Location: Chicago, IL

Duration: 3 Months, Contract to Hire

Support of The Following Applications:

  • QNXT – claims and utilization system
  • Experience as a BA big plus
  • Member benefits configuration including all applicable risks, terms and copays
  • Optum360 – medical codes compliance
  • Claim Check (Change Health Care) – claims adjudication
  • Fee Schedules – CMS, payer, carve-outs
  • Change Health Care
  • Availity Provider Portal (under implementation)

Accountabilities:

  • Monitoring of claims adjudication, errors and configuration analysis and resolution
  • Maintenance of system tables including:
  • Fee schedules
  • HCPC/CPT/REV codes
  • Member Benefits
  • Provider Contracts and Capitation
  • Operational Projects including:
  • Member benefit validation
  • Laboratory Capitation Adjustments
  • Claims configuration for encounter errors