- Highmark Health (Santa Fe, NM)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding,… more
- CVS Health (Santa Fe, NM)
- …through measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, ... 2+ years of experience working with diagnosis codes and medical terminology. + Moderate to advanced knowledge of Excel...and decision making skills + College degree preferred + Claims experience + DG experience **Education** + High School… more
- Molina Healthcare (NM)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Medical Economics Team activities and personnel. Provides technical expertise,… more
- Cognizant (Santa Fe, NM)
- …processes, training, continuous improvement, system automation. + System health monitoring of: Claim adjudication jobs, ASP alerts, CPU alerts, Claims queue ... team is responsible for 24x7x365 monitoring of all IBM i LPARS, along with processing all backups. This role will also involve monitoring the IBM i RxClaim health,… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …as the primary technical subject matter expert (SME) for downstream processing (chromatography, TFF/UFDF, viral clearance/filtration, etc.). + Lead and manage the ... sections of regulatory submissions (IND, BLA, MAA, etc.) related to downstream processing . + Collaborate closely with Upstream MSAT, Validation MSAT, QA, Regulatory,… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …+ Serve as the primary technical subject matter expert (SME) for upstream processing (cell culture/fermentation, harvest). + Lead and manage the technical aspects of ... sections of regulatory submissions (IND, BLA, MAA, etc.) related to upstream processing . + Collaborate closely with Downstream MSAT, Validation MSAT, QA, Regulatory,… more
- Molina Healthcare (Santa Fe, NM)
- …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... accordance with states and local laws. **Company benefits** : Comprehensive medical , dental, vision, prescription drug coverage, company provided basic life,… more
- Mass Markets (Las Cruces, NM)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... support inbound customer service, help desk, technical support, and back-office processing representatives for commercial and public sector support positions. In… more
- Mass Markets (Las Cruces, NM)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... service representatives to support inbound customer service, help desk, and back-office processing for commercial and public sector support positions. In this role,… more