- Prime Therapeutics (Santa Fe, NM)
- …fuels our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit ... and adjustments as required. + Implementation and maintenance of claims processing programs and procedures + Verify...and administrative duties as required by business need. + Lead and implement positive changes with a high level… more
- Humana (Santa Fe, NM)
- …to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a dynamic, mission-driven ... help us put health first** As a Process Improvement Lead , you'll play a key role in analyzing and...+ 2+ years of demonstrated expertise in end-to-end healthcare claims operations, including claim ingestion, processing , system… more
- Molina Healthcare (NM)
- …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Create succinct ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (NM)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims ... accuracy and compliance of Coordination of Benefits (COB) claim pricing and processing . This role will focus on identifying, reviewing, and validating Medicaid… more
- Molina Healthcare (Albuquerque, NM)
- …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... **Job Description** **Job Summary** Provides lead level support as a highly capable business...operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …visible leadership position has been designed for an executive marketing professional to lead the US Centanafidine launch, a novel treatment for ADHD. The compound ... launch that results in significant contribution to overall brand growth and lead commercial team members responsible for creating and implementing brand strategy… more
- Highmark Health (Santa Fe, NM)
- …progressions, and treatment efficacy? Highmark Health is seeking a groundbreaking Lead Data Scientist, Research & Development, specializing in Graph Intelligence, ... insights in healthcare. This is a premier R&D position where you will lead the charge in inventing and proving out transformative graph-native analytical solutions.… more
- Humana (Santa Fe, NM)
- …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... of our caring community and help us put health first** The Medicaid Lead , Technology Solutions builds strategic partnerships and manages relationships between IT and… more
- Walmart (Las Cruces, NM)
- …types programs and benefits to current and prospective members processing memberships upgrades and credit accounts encouraging membership renewals participating ... up orders are filled Oversees assigned area of responsibility by handling claims and returns zoning the area arranging and organizing merchandise identifying shrink… more
- Cardinal Health (Santa Fe, NM)
- …+ Mails all paper claims . + Acts as a subject matter expert in claims processing . + Manages billing queue as assigned in the appropriate system. + Manages ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will...Mentors new hires; assists + Assists management and team lead with motivating and coaching employees to succeed as… more