13 Qnxt Jobs

As a Test Lead in our team, you will be responsible for leading testing activities within the Healthcare Industry. With 8-10 years of experience in Manual and Automation Testing, your role will involve working extensively on Agile Methodology. Your expertise in SQL, functions, views, and procedures will be crucial, along with a deep understanding of FACETS or QNXT modules such as Claims and Enrollments. You will play a key role in Healthcare, focusing on EDI files processing, managing a small team, and resolving issues efficiently. Exceptional problem-solving and troubleshooting skills are essential for this position. Your responsibilities will include managing Testing Scope, SLAs, communication, risks, and issues. Reviewing and analyzing project requirements, creating test schedules, and designing test strategies will be part of your daily tasks. You will identify the testing scope for each release based on the requirements document and collaborate with developers to address defects and application issues. Understanding End to End Business Scenarios and Software Test Life Cycle processes is crucial. Your role will involve holding meetings within the test team, generating test reports, and interacting with stakeholders. You will coordinate with the Automation team to identify test cases suitable for automation. Leading, guiding, and monitoring the analysis, design, and execution of test cases and procedures will be part of your responsibilities. Throughout the project, you will schedule tests for execution, monitor progress, control test results, and adapt the test plan as needed. Communication skills, including speaking, writing, and presentation abilities, are vital for interacting with customers, SMEs, and stakeholders. Qualifications: - BE - Minimum 5 years to maximum 8 years of experience in relevant field,

Title/Designation : Product Consultant/ Payer Integration Lead/Architect Role : Payer Core Solutioning Location : Navi Mumbai/ Pune/ Bangalore/ Chennai/ Gurgaon/ Hyderabad Work Mode: Hybrid Exp: 12 to 15 years Role & responsibilities: Candidate will be part of our Payer consulting team, responsible for working with clients on implementing key solutions, work closely with client account leads in identifying new transformational opportunities with accounts and develop proactive proposals thereby contributing to overall account growth and client success Actively participate in client presentations, proposal walkthroughs, demos to convey CitiusTech solution & value proposition Work with customer delivery and field teams and educating on roadmaps and delivery. Single handedly drive & own the sales support process in coordination with Sales / Account Management leads, Delivery leads, other Architects Provide consulting and domain thought leadership to customers, company and teams Preferred candidate profile: 12 - 15 years experience in any one or more sub-sectors of Healthcare such as Payers i.e. Health Insurance preferably in the US market as Healthcare Consultant. More than 10 years hands-on experience on TriZettos platforms (either Facets or QNXT) or any other leading US claims platforms in a Technical Architect / Lead / role Deep knowledge of core payer processes incl. member enrolment, provider, claims, authorizations, payments, contact center etc. Design and architect robust integration solutions encompassing data flows, APIs, message routing, transformation, orchestration, and infrastructure considerations Deep understanding of integration patterns, architectures, and technologies, including ESB, message brokers, data integration tools, APIs, and web services. Experience developing efficiency tools incl. accelerators, best practices, automation scripts etc. Navigate complexities and ambiguities with client ask or industry trend to clearly document & present CitiusTech solution & expertise Ability to understand the client problem statement and strong analytical skills for identifying the possible solution Ability to build professional relationships, a spirit of co-operation, and a flexible approach to work are required Experience in defining themes, epics, stories for requirements, experience of working in Agile Scrum Experience of working in cloud and hybrid environments incl. use of cloud-native services, containerization, CI/CD pipelines Good understanding of SDLC process and experience working with development teams to ensure successful delivery of solutions Self-motivated and strong team player Ability to work in a fast paced, entrepreneurial environment Strong verbal and written communication skills Travel Expected travel: Short term to US to meet customers and internal planning and discussions, as and when required (Post Covid) Travel within India as required for project work or internal meetings

Title/Designation : Product Consultant/Architect Role : Customer Success - Payer Core Solutioning Location : Navi Mumbai/ Pune/ Bangalore/ Chennai/ Gurgaon/ Hyderabad Work Mode: Hybrid Exp: 12 to 15 years Role & responsibilities: Candidate will be part of our Payer consulting team, responsible for working with clients on implementing key solutions, work closely with client account leads in identifying new transformational opportunities with accounts and develop proactive proposals thereby contributing to overall account growth and client success Actively participate in client presentations, proposal walkthroughs, demos to convey CitiusTech solution & value proposition Work with customer delivery and field teams and educating on roadmaps and delivery. Single handedly drive & own the sales support process in coordination with Sales / Account Management leads, Delivery leads, other Architects Provide consulting and domain thought leadership to customers, company and teams Preferred candidate profile: 12 - 15 years experience in any one or more sub-sectors of Healthcare such as Payers i.e. Health Insurance preferably in the US market as Healthcare Consultant. More than 10 years hands-on experience on TriZettos platforms (either Facets or QNXT) or any other leading US claims platforms in a Technical Architect / Lead / role Deep knowledge of core payer processes incl. member enrolment, provider, claims, authorizations, payments, contact center etc. Design and architect robust integration solutions encompassing data flows, APIs, message routing, transformation, orchestration, and infrastructure considerations Deep understanding of integration patterns, architectures, and technologies, including ESB, message brokers, data integration tools, APIs, and web services. Experience developing efficiency tools incl. accelerators, best practices, automation scripts etc. Navigate complexities and ambiguities with client ask or industry trend to clearly document & present CitiusTech solution & expertise Ability to understand the client problem statement and strong analytical skills for identifying the possible solution Ability to build professional relationships, a spirit of co-operation, and a flexible approach to work are required Experience in defining themes, epics, stories for requirements, experience of working in Agile Scrum Experience of working in cloud and hybrid environments incl. use of cloud-native services, containerization, CI/CD pipelines Good understanding of SDLC process and experience working with development teams to ensure successful delivery of solutions Self-motivated and strong team player Ability to work in a fast paced, entrepreneurial environment Strong verbal and written communication skills Travel Expected travel: Short term to US to meet customers and internal planning and discussions, as and when required (Post Covid) Travel within India as required for project work or internal meetings

Title/Designation : Sr. Payer Integration Lead / Architect Role : Customer Success - Payer Core Solutioning Location : Navi Mumbai/ Pune/ Bangalore/ Chennai/ Gurgaon/ Hyderabad Work Mode: Hybrid Exp: 12 to 15 years Role & responsibilities: Candidate will be part of our Payer consulting team, responsible for working with clients on implementing key solutions, work closely with client account leads in identifying new transformational opportunities with accounts and develop proactive proposals thereby contributing to overall account growth and client success Actively participate in client presentations, proposal walkthroughs, demos to convey CitiusTech solution & value proposition Work with customer delivery and field teams and educating on roadmaps and delivery. Single handedly drive & own the sales support process in coordination with Sales / Account Management leads, Delivery leads, other Architects Provide consulting and domain thought leadership to customers, company and teams Preferred candidate profile: 12 - 15 years experience in any one or more sub-sectors of Healthcare such as Payers i.e. Health Insurance preferably in the US market as Healthcare Consultant. More than 10 years hands-on experience on TriZettos platforms (either Facets or QNXT) or any other leading US claims platforms in a Technical Architect / Lead / role Deep knowledge of core payer processes incl. member enrolment, provider, claims, authorizations, payments, contact center etc. Design and architect robust integration solutions encompassing data flows, APIs, message routing, transformation, orchestration, and infrastructure considerations Deep understanding of integration patterns, architectures, and technologies, including ESB, message brokers, data integration tools, APIs, and web services. Experience in working with Java and its related technologies such as Hibernate, Spring, Spring Boot, JPA, webservices, Tomcat Application Server Experience developing efficiency tools incl. accelerators, best practices, automation scripts etc. Experience of working in cloud and hybrid environments incl. use of cloud-native services, containerization, CI/CD pipelines Navigate complexities and ambiguities with client ask or industry trend to clearly document & present CitiusTech solution & expertise Ability to understand the client problem statement and strong analytical skills for identifying the possible solution Ability to build professional relationships, a spirit of co-operation, and a flexible approach to work are required Self-motivated and strong team player Ability to work in a fast paced, entrepreneurial environment Experience in defining themes, epics, stories for requirements, experience of working in Agile Scrum Good understanding of SDLC process and experience working with development teams to ensure successful delivery of solutions Strong verbal and written communication skills Travel Expected travel: Short term to US to meet customers and internal planning and discussions, as and when required (Post Covid) Travel within India as required for project work or internal meetings

Title/Designation : Sr. Payer Integration Lead / Architect Role : Customer Success - Payer Core Solutioning Location : Navi Mumbai/ Pune/ Bangalore/ Chennai/ Gurgaon/ Hyderabad Work Mode: Hybrid Exp: 12 to 15 years Role & responsibilities: Candidate will be part of our Payer consulting team, responsible for working with clients on implementing key solutions, work closely with client account leads in identifying new transformational opportunities with accounts and develop proactive proposals thereby contributing to overall account growth and client success Actively participate in client presentations, proposal walkthroughs, demos to convey CitiusTech solution & value proposition Work with customer delivery and field teams and educating on roadmaps and delivery. Single handedly drive & own the sales support process in coordination with Sales / Account Management leads, Delivery leads, other Architects Provide consulting and domain thought leadership to customers, company and teams Preferred candidate profile: 12 - 15 years experience in any one or more sub-sectors of Healthcare such as Payers i.e. Health Insurance preferably in the US market as Healthcare Consultant. More than 10 years hands-on experience on TriZettos platforms (either Facets or QNXT) or any other leading US claims platforms in a Technical Architect / Lead / role Deep knowledge of core payer processes incl. member enrolment, provider, claims, authorizations, payments, contact center etc. Design and architect robust integration solutions encompassing data flows, APIs, message routing, transformation, orchestration, and infrastructure considerations Deep understanding of integration patterns, architectures, and technologies, including ESB, message brokers, data integration tools, APIs, and web services. Experience developing efficiency tools incl. accelerators, best practices, automation scripts etc. Navigate complexities and ambiguities with client ask or industry trend to clearly document & present CitiusTech solution & expertise Ability to understand the client problem statement and strong analytical skills for identifying the possible solution Ability to build professional relationships, a spirit of co-operation, and a flexible approach to work are required Experience in defining themes, epics, stories for requirements, experience of working in Agile Scrum Experience of working in cloud and hybrid environments incl. use of cloud-native services, containerization, CI/CD pipelines Good understanding of SDLC process and experience working with development teams to ensure successful delivery of solutions Self-motivated and strong team player Ability to work in a fast paced, entrepreneurial environment Strong verbal and written communication skills Travel Expected travel: Short term to US to meet customers and internal planning and discussions, as and when required (Post Covid) Travel within India as required for project work or internal meetings

Role: QNXT Configuration and SI Mandatory Skill: QNXT, Config, SQL Responsibilities To analyze and understand requirements, design, develop, unit test and document test results for Facets/FACETS interfaces development tasks. Exposure to QNXT / QNXT data model, QNXT core batches & SQL & .Net skills required. Hands on experience in QNXT claims & Enrolment QNXT system implementation role to analyze and understand requirements, design, develop, unit test and document test results for QNXT interfaces and reports development tasks Exposure and basic understanding of core QNXT functions such as claims, membership, and provider would be desired along with working knowledge on underlying data models. This role will also require effective coordination/communication as required to get technical clarifications/questions sorted out with onsite teams for a quality deliverable and support system integration testing done by testing teams. Requirements Overall Experience: 3+ years in developing QNXT applications. Mandatory Experience- Should have a domain exp in Healthcare & QNXT with System implementation and production support. Should have a technical experience in C# (or) Dot net with SQL (or) MS SQL (or) PLSQL Should have expertise in Agile process and capability to work individually and target for quality deliverable

Role & responsibilities Preferred candidate profile 1-6 years experience in Benefits configuration Mandate skills: Qnxt,Facets,SQL,Benefits configuration Mode: WFH Any Graduates Flexible to work night shifts

Role & responsibilities Preferred candidate profile 1-5 years experience in claims with facets US Healthcare Flexible to work US shifts Work location: Chennai/ Hyd/Coimbatore Work Mode: WFH (Temporary)

Dear Applicants Hiring for Benefit Configuration - WFH Location: Pan India Position: TL & SDM Shift: US shift, WFH Notice: Up to 1month Qualification: Graduate with Science, Arts or commerce background Ctc - TL: 10lpa, SDM: 18.5lpa Skills : 5 to 11 years US Healthcare skills in claims and Benefit configuration with SQL / QNXT tool expr required. Good Communication skills (Oral & Written). Addressing and resolving escalated issues in the appropriate manner within the appropriate timeframe and escalates as appropriate. Energy and Drive. Ability to build and expand relationships. Diligence & Persistence Willingness to travel. RESPONSIBILITIES : Performing Member enrollment, design, coding on Customer specific solutions during the client product implementation stage and ongoing support and maintenance of quality custom solutions. Coding - Assign codes to diagnosis and procedures performed during implementation. Coding the procedure codes in Code Grouper and mapping them to service groups. Reinstatement of medical codes (CPT, HCPCs & Revenue codes) Addition and deletion of codes on frequent basis Sharing the OPTUM codes (Customer Exchange) updates with BRC Identifying contracts and Benefits to map the new codes based on the services. Writing SQL queries to validate the data and pulling test cases from the database Running SQL queries and converting the output into a text files to move the data from BRC Configuration environment to Client environments Creating the Change Controls to setup the Migration process through which data moves to Production region Error Root cause Analysis and Counseling Attending Onshore and client calls Coordinating with management and different teams within membership to clean the inventory and to support each other during need hours. Should contribute to Project Test Planning, as per direction(s) from Team Lead/Group Lead Providing prompt resolution to the team if any query arises. To appoint a backup for any resource on PTO. Making sure that the deliverables and Quality of work is maintained. Interested Candidates contact HR Pallavi @9167757169 / pallavi@careerguideline.com

Cognizant is hiring Encounter Submission Specialist (US Healthcare) for Hyderabad location. Job Title: Team Manager Experience - 8 - 11 Years Job Location: Hyderabad (relocation benefits available for other location candidates) Mode of Work - Work from Office Shifts - Mid Shift - (1 PM IST to 11 PM IST) Candidates with 8 - 11 years of experience particularly from Encounter submission background US Healthcare Knowledge. E.g. Encounter, EDI, HIPAA, 837 Layout, insights into Medicare and Medicaid , Markets etc. Facets/QNXT or any other healthcare adjudication system knowledge will be an added advantage. SQL Server - SSIS or SSRS plus any Microsoft cloud technologies will be an added advantage. Analytical and Query Writing Skills (SQL) - Joint query, structured query, creating tables, running reports in SQL etc SQL Procedure and Packages, Debugging skills. Knowledge on any reporting tools or software e.g. Tableau or Power BI etc. Should be good at communication skills Interested, kindly share your updated resume to the below email pragya.shrivastav@cognizant.com

Cognizant is hiring Encounter Submission Specialist (US Healthcare) for Hyderabad location. Job Title: Team Leader Experience - 5 - 8 Years Job Location: Hyderabad (relocation benefits available for other location candidates) Mode of Work - Work from Office Shifts - Mid Shift - (1 PM IST to 11 PM IST) Candidates with 5 - 8 years of experience particularly from Encounter submission background US Healthcare Knowledge. E.g. Encounter, EDI, HIPAA, 837 Layout, insights into Medicare and Medicaid , Markets etc. Facets/QNXT or any other healthcare adjudication system knowledge will be an added advantage. SQL Server - SSIS or SSRS plus any Microsoft cloud technologies will be an added advantage. Analytical and Query Writing Skills (SQL) - Joint query, structured query, creating tables, running reports in SQL etc SQL Procedure and Packages, Debugging skills. Knowledge on any reporting tools or software e.g. Tableau or Power BI etc. Should be good at communication skills Interested, kindly share your updated resume to the below email pragya.shrivastav@cognizant.com

BA SQL Medicaid US Healthcare, Medicaid, Claims, SQL, QNXT, Facets Gather and analyze business requirements from stakeholders Document BRDs, FRDs, and user stories for development teams Facilitate communication between business and technical teams Conduct gap analysis and suggest improvements Support UAT, training, and deployment activities Create process flowcharts, data models, and presentations Track project progress and provide status updates to leadership

SUMMARY Job Title: Healthcare Claims Associate German Language Location: Powai, Mumbai Experience Level: 1 6 years Employment Type: Full-time Shift: UK shift Job Summary: We are looking for a detail-oriented and multilingual professional to join our healthcare operations team as a Healthcare Claims Associate with fluency in German . The ideal candidate will be responsible for processing, reviewing, and validating healthcare claims in accordance with company policies and healthcare regulations. Fluency in German is essential as the role involves interpreting and processing claims originating from German-speaking regions. Key Responsibilities: Review, verify, and process healthcare claims using internal systems. Analyze submitted medical documents and ensure compliance with insurance policies. Translate and interpret medical and insurance documents from German to English and vice versa. Communicate with German-speaking clients, hospitals, or insurance providers as required. Identify and flag any inconsistencies or fraudulent claims. Collaborate with internal teams to resolve claim issues and escalate when needed. Maintain accurate records and documentation of all claim activities. Ensure adherence to SLAs and quality metrics. Qualifications & Skills: Bachelor's degree in Healthcare, Business Administration, or a related field. Fluency in German (B2/C1 level or higher) verbal and written. 1 6 years of experience in healthcare claims processing or insurance domain preferred. Strong understanding of medical terminology and healthcare billing systems. Familiarity with ICD, CPT codes, and healthcare regulations is a plus. Excellent communication, analytical, and problem-solving skills. Ability to work in a fast-paced and deadline-driven environment. Experience with tools like Facets, QNXT, or other claims adjudication systems is a plus. Preferred: Certification in German language (Goethe, TestDaF, or equivalent). Experience working with European or German healthcare clients.