- Mass Markets (Las Cruces, NM)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... MCI Federal Services (MFS), OnBrand24, The Sydney Call Center, Valor Intelligent Processing (VIP), BYC Aqua, EastWest BPO, TeleTechnology, and Vinculum. The purpose… more
- Molina Healthcare (Roswell, NM)
- …Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains ... point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other necessary information to providers, members and pharmacies. * Assists with… more
- Ryder System (Santa Fe, NM)
- …action plans if deficiencies are noted. Monitors staff's workflow to ensure accurate processing of claims , timely establishment of reserves, reviews and logs ... : **SUMMARY** This position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …improvement **Cross-functional Integration** + Serve as the primary field medical affairs representative to the Rare Disease Medical Business Unit Lead and core ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …continuous improvement and compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews and/or other ad ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Mass Markets (Las Cruces, NM)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... POSITION OVERVIEW CUSTOMER SERVICE REPRESENTATIVE SUPPORTING COMMERCIAL AND PUBLIC SECTOR CLIENTS We...to support inbound customer service, help desk, and back-office processing representatives for commercial and public sector support positions.… more
- Highmark Health (Santa Fe, NM)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more