Req: QNXT Claims Examiner @ Los Angeles, CA
Title: QNXT Claims Examiner
Location: Los Angeles, CA
Main Responsibilities
• Complex healthcare payer claims processing
• Identify and investigate system and benefit discrepancies and
follow through with proposed resolution
• Identification and implementation of process improvements and
efficiencies
• Exhibit a spirit of teamwork and contribute ideas for
division and company success
• Perform special projects and participate in workgroups to
improve internal processes as needed
• Interaction with business users for requirement clarification
and resolution of incidents reported
• Responsible for root cause analysis for major incidents
• Coordination with Business Units and Development Teams
Qualifications
• High school graduate
Skills
• Experience on QNXT claims platform
• Health insurance background
• Strong analytical abilities
• PC skills
• 45+ WPM typing speed preferred
• Experience in identifying upstream and downstream system
impact
Experience
• Strong QNXT knowledge
• Knowledge of processing SPD/Institutional and Medical Only
claims on QNXT
• Should have the ability to work in high pressure environment
• Minimum experience 6 years as a claims examiner
• Medical Claims Knowledge - Payer Claims Processor, or Medical
Billing, or Customer Service Representative for healthcare payer
• Ability to quickly adapt to process changes
• Comfortable working in a production environment
• Demonstrated ability to process a high volume of claims in a
fast-paced environment
• Recent work history that supports excellent organization,
problem-solving, communication, teamwork and interpersonal skills
• Demonstrated flexibility and willingness to change as
business needs change within the organization
• Proven written and verbal communication skills essential
• Proven problem solver who can work under their own initiative
• Good analytical, problem solving, Communication and
Interpersonal skills
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*Thanks + Regards,*
*George,*
*("Call ME only if your emails are unanswered"),*
*347-815-4828,*
*G-talk / YIM/ Skype**: George.humanresource*
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