QNXT QA Tester (Provider Contract Configuration)

Job Title: QNXT QA Tester – Provider Contract Configuration
Duration: Long Term Contract
Location: Remote
Job Summary
We are seeking an experienced QNXT QA Tester with strong functional testing experience and hands-on knowledge of Provider Contract Configuration within the TriZetto QNXT healthcare administration platform.
The ideal candidate will have experience validating provider contract setups, reimbursement methodologies, fee schedules, claims pricing, and payment configurations. The candidate should understand how provider contract configurations impact claims adjudication and reimbursement.
Key Responsibilities
Perform functional, regression, integration, and end-to-end testing of QNXT applications.
Validate provider contract configurations, including contract terms, reimbursement rates, fee schedules, and payment methodologies.
Test provider network participation, provider affiliations, and provider demographic configurations.
Validate claims pricing and adjudication against configured provider contracts.
Test reimbursement methodologies such as Fee-for-Service, Per Diem, Case Rates, DRG, and other applicable payment arrangements.
Validate CPT, HCPCS, ICD-10, Revenue Codes, and modifiers used in claims processing.
Execute test scenarios covering professional, institutional, and facility claims.
Analyze configuration-related defects and identify discrepancies in claims payment calculations.
Use SQL queries to validate backend data and claims processing results.
Collaborate with QNXT configuration analysts, business analysts, developers, and business teams.
Support UAT, defect triage, test documentation, and release validation.
Required Skills
Hands-on experience with TriZetto QNXT.
Strong understanding of Provider Contract Configuration.
Experience testing provider reimbursement and payment methodologies.
Knowledge of healthcare claims adjudication and processing.
Experience with provider setup, provider networks, and fee schedules.
Strong functional testing and regression testing experience.
SQL knowledge for backend validation.
Experience with defect management tools such as Jira or HP ALM.