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FULLY REMOTE ROLE – EASTERN TIME (EST) WORKING HOURS
QNXT Commercial Billing Subject Matter Expert (SME)
Position Overview
Seeking an experienced QNXT Commercial Billing SME with deep, hands-on expertise in implementing and configuring commercial premium billing solutions within QNXT. This individual will lead functional and technical billing activities, including configuration, integrations, payment processing, and end-to-end billing implementation.
This is a hands-on QNXT commercial premium billing role, not a general QNXT claims or core administration position.
NOTE:
The candidate MUST have direct, hands-on QNXT commercial premium billing implementation and configuration experience.
Candidates with only QNXT claims processing, benefits configuration, enrollment, or general core administration experience will not qualify without demonstrated commercial premium billing expertise.
Must-Have Qualifications
- QNXT Commercial Premium Billing: Extensive hands-on experience implementing and configuring the QNXT premium billing module.
- QNXT Data Model & Configuration: Strong knowledge of QNXT billing data structures, configuration, and standard functionality.
- Commercial Health Plan Experience: Experience supporting individual, group, self-funded, and/or level-funded commercial products.
- End-to-End Premium Billing: Expertise in enrollment data, premium calculations, bill generation, invoicing, payment processing, posting, reconciliation, and reporting.
- QNXT Integrations: Experience defining inbound/outbound interfaces for enrollment, billing, payment files, banking systems, billing presentment, and reporting.
- Implementation & Fit-Gap Analysis: Proven ability to translate business requirements into QNXT configurations, identify functional gaps, and determine configuration versus customization needs.
- Billing Troubleshooting: Experience resolving billing discrepancies involving retroactive adjustments, enrollment changes, subsidies, payment posting, and reconciliation.
- Stakeholder Collaboration: Ability to work independently with business, technical, integration, and billing operations teams.
- Experience migrating commercial premium billing from external platforms into QNXT.
- Experience with multi-market or multi-product commercial health plan implementations.
- Knowledge of complex billing scenarios, including retroactivity, subsidies, dunning, and reconciliation.
- Experience integrating QNXT with external banking, payment processing, and billing-presentment solutions.
Interested candidates may submit their resumes online or call at 310-906-4780 for further information regarding the position.
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