- Molina Healthcare (NM)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments...years operational managed care experience (call center, appeals or claims environment). + Health claims processing… 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...company policy, regulations, or third-party policy. + More challenging claim cases + Investigates and updates the system with… more
- APTIM (Santa Fe, NM)
- … management software, databases, and other technology tools that facilitate claim processing , documentation, and communication. **Basic Qualifications:** + High ... Xactimate) preferred. + A minimum of five (5) years of combined experience in claims or case processing roles, including customer service, data entry, reviewing,… more
- Cardinal Health (Santa Fe, NM)
- …reviewing, and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard ... administration, customer and vendor pricing, rebates, billing (including dropships), processing charge backs and vendor invoices, developing and negotiating customer… more
- CDM Smith (Albuquerque, NM)
- …CDM Smith has been supporting FEMA for two years in developing policy, procedures, and processing claims in support of the Hermit's Peak Calf/Canyon fire. We are ... looking for additional staff to process claims with a focus on high quality output. Staff...and make recommendations to FEMA as to whether the claim is eligible. Assists with the development of the… more
- Molina Healthcare (NM)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Molina Healthcare (Rio Rancho, NM)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible for ... certain assets within the broader CNS TA portfolio Medical Affairs (both US and Global), with a specialization...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Position Summary** : Reporting to the Vice President, Global Medical Affairs, the Executive Director, CNS Strategy, Global Medical Affairs is a leadership ... position responsible for the strategic and tactical medical plans of both global and US ...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
- Norstella (Santa Fe, NM)
- Sr. Medical Analyst Company: MMIT Location: Remote, United States Date Posted: Jul 30, 2025 Employment Type: Full Time Job ID: R-1370 **Description** **Why ... to market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role,… more