- Sedgwick (Santa Fe, NM)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- APTIM (Santa Fe, NM)
- … management software, databases, and other technology tools that facilitate claim processing , documentation, and communication. **Basic Qualifications:** + High ... Claims Reviewer is responsible for independently reviewing, analyzing, and processing complex claims related to disaster losses in accordance with… more
- APTIM (Santa Fe, NM)
- … management software, databases, and other technology tools that facilitate claim processing , documentation, and communication. **Basic Qualifications:** + High ... claims management systems, databases, and other technology tools that facilitate claim processing , documentation, and communication **ABOUT APTIM** APTIM is… more
- Sedgwick (Santa Fe, NM)
- …FUNCTIONS and RESPONSIBILITIES** + Processes auto property damage and lower level injury claims ; assesses damage, makes payments, and ensures claim files are ... and pursues subrogation opportunities; secures and disposes of salvage. + Communicates claim action/ processing with insured, client, and agent or broker when… more
- Molina Healthcare (Roswell, NM)
- …errors of claims . + Manages a caseload of claims . Procures all medical records and statements that support the claim . + Makes recommendations for further ... **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of … more
- Reynolds & Reynolds (Albuquerque, NM)
- …will include, but are not limited to:-\tAnswering inbound calls-\tProvide information about claim processing and explain the different levels of contract ... coverage and terms -\tAccurately establish, review and authorize claims -\tEntering claim and contract information into the AGWS\u2019 systemA home office package… more
- IQVIA (Las Cruces, NM)
- …+ HIPAA certified + Call center experience required (3+ years preferred) + Experience in medical claim processing is a plus + Bi-lingual (English/Spanish) is ... what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need… more
- Humana (Santa Fe, NM)
- …**Use your skills to make an impact** **Required Qualifications** **5+ years of medical claims processing /auditing or encounter data management experience** ... team leadership experience** **Demonstrated experience in managing projects effectively** ** Medical claims experience** **Additional Information** **_This position… more
- Humana (Santa Fe, NM)
- …skills to make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience ... cross functional teams and support analyzing business processes, error processing , issues and ticket creations with the product management...analyzing and researching medical claims + Proficient in Microsoft Office… more
- Humana (Santa Fe, NM)
- …+ Grievance and appeals experience + Prior experience interpreting Member Benefits and Medical Claims + Previous experience processing medical ... + Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of medical... Claims Administration System (CAS) + Knowledge of medical terminology + Ability to manage large volume of… more