Robotic Process Automation (RPA) Developer / Analyst with QNXT

We are seeking a skilled Robotic Process Automation (RPA) Developer / Analyst to design, develop, and implement automated solutions for healthcare claims processing using RPA platforms (such as UiPath, Blue Prism, or Automation Anywhere) integrated with QNXT — a core claims processing and healthcare administration system widely used by health plans and managed care organizations. This role bridges healthcare operations, business process knowledge, and automation technologies to streamline and optimize claims handling, improving accuracy, compliance, and efficiency.

Key Responsibilities:

• Collaborate with business teams (claims processors, underwriters, IT, compliance) to analyze and document healthcare claims workflows currently processed in QNXT.
• Design, develop, test, and deploy RPA bots that automate repetitive and rule-based tasks in the claims lifecycle, such as claims intake, data validation, adjudication, eligibility checks, and payment processing.
• Integrate RPA bots with QNXT’s interfaces (e.g., screen scraping, API integration, data extraction/input) to ensure seamless automation of core claim functions.
• Monitor, maintain, and troubleshoot RPA solutions to ensure sustained performance, accuracy, and compliance with healthcare regulations (e.g., HIPAA).
• Identify opportunities for continuous improvement in claims workflows and automation strategies to drive operational efficiency.
• Ensure detailed documentation of RPA solutions, process maps, and technical specifications for audit, compliance, and maintenance purposes.
• Collaborate with Quality Assurance and Compliance teams to validate automated processes meet regulatory standards and business rules.
• Stay up to date with RPA and healthcare industry trends to recommend new automation opportunities and best practices.

Required Skills & Experience:

• Strong understanding of healthcare claims processing, medical coding (ICD, CPT), and health plan operations — especially with QNXT platform workflows.
• Experience designing and developing RPA bots using platforms like UiPath, Automation Anywhere, or Blue Prism (UiPath is the most common for healthcare).
• Familiarity with QNXT’s system architecture, user interface, and data models, including hands-on experience navigating and extracting/manipulating data within QNXT.
• Knowledge of healthcare regulatory standards such as HIPAA, CMS rules, and managed care policies relevant to claims processing.
• Strong analytical skills for process analysis, business rules understanding, and workflow documentation.
• Programming / scripting experience (e.g., VB.NET, Python, SQL) is a plus for advanced RPA development.
• Excellent communication skills to liaise between IT, business users, and compliance teams.

Preferred Qualifications:

• Prior experience automating QNXT claims workflows specifically (e.g., claims adjudication, provider data management, or member eligibility processing).
• Experience working in a payer-side healthcare environment (health insurance company or managed care organization).
• Certification in an RPA platform (e.g., UiPath Certified RPA Developer).