Job ID: JOB_ID_8624
About the Role:
We are seeking a skilled QNXT Medicaid Tester to play a critical role in ensuring accurate claims adjudication, enrollment processing, and regulatory compliance within complex healthcare payer systems. Join us as we support enterprise Medicaid programs powered by the TriZetto QNXT platform and drive high-quality, compliant healthcare solutions.
Key Responsibilities:
- Validate Medicaid-focused claims processing, enrollment, premium billing, and encounter reporting within QNXT.
- Test rules-driven claims adjudication, pricing logic, and benefit configurations.
- Support end-to-end testing cycles including functional, integration, regression, performance, and data validation.
- Ensure compliance with state and federal Medicaid regulations.
- Collaborate with business analysts, QA teams, and project managers to resolve configuration gaps.
Required Qualifications:
- 3-7 years of experience in QNXT testing within Medicaid environments.
- Strong understanding of Medicaid operations (UM, Prior Authorization, Capitation, PMPM, TPL/COB).
- Hands-on experience with 834, 820, NCPDP file formats and MMIS submissions.
- Experience with test planning, execution, defect tracking & validation within QNXT.
Preferred Qualifications:
- Experience with large payer organizations or Medicaid agencies.
- Strong analytical mindset with excellent documentation & stakeholder communication skills.
- Experience supporting QNXT upgrades, releases, and audit readiness documentation.
Employment Type:
US-Based (Full-Time)
Why Join Us:
We value detail-oriented professionals who understand Medicaid compliance, enjoy solving complex claims scenarios, and can ensure accurate QNXT configurations in dynamic healthcare environments.
Compensation & Location
Salary: $70,000 – $120,000 per year (Estimated)
Location: Remote
Recruiter / Company – Contact Information
Email: i@artigencetech.com
Recruiter Notice:
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