QNXT QA Tester (Provider Contract Configuration)

Quick Facts

• Role: QNXT QA Tester (Provider Contract Configuration)
• Work mode: Remote
• Duration: Long Term Contract

Description

Long-term remote contract role for an experienced QNXT QA Tester specializing in Provider Contract Configuration. Validate provider contract setups and ensure claims pricing and reimbursement calculations are accurate across configured contract terms and reimbursement methodologies. Support UAT, defect triage, test documentation, and release validation.

Responsibilities

• Perform functional, regression, integration, and end-to-end testing of QNXT applications.
• Validate provider contract configurations: 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 including Fee-for-Service, Per Diem, Case Rates, DRG, and other applicable arrangements.
• Validate CPT, HCPCS, ICD-10, Revenue Codes, and modifiers used in claims processing.
• Execute test scenarios for 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.

Requirements

• 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.