• Senior Process Improvement Professional

    Humana (Santa Fe, NM)
    …+ Minimum 1 year of experience medical claims payment and processing in a medical claim 's environment + Experience creating pivot tables ... health care industries or related adjacent industries **Additional Information** **Work-At- Home Requirements:** + WAH requirements: Must have the ability to… more
    Humana (08/27/25)
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  • Grievance & Appeals Representative

    Humana (Santa Fe, NM)
    …+ Grievance and appeals experience + Prior experience interpreting Member Benefits and Medical Claims + Previous experience processing medical ... speak English and Spanish + Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of medical terminology + Ability… more
    Humana (09/02/25)
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  • Encounter Data Management Professional

    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 (08/16/25)
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  • Senior Encounter Data Management Professional

    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 (08/15/25)
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  • Remote Bilingual Customer Service Representative

    Mass Markets (NM)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... to resolve issues when needed + Accurately document and process customer claims in appropriate systems + Utilize knowledge base and training to accurately… more
    Mass Markets (08/28/25)
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  • Analyst, Integration Quality

    Evolent (Santa Fe, NM)
    …of 1 years of experience in technical quality assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable ... to analyze source & target integrity across various databases supporting transaction processing based on the end-to-end data flow + create & maintain queries… more
    Evolent (08/29/25)
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  • Republican Fundraising Representative

    Mass Markets (NM)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,...support in a contact center environment + Work at home experience + State or Federal work experience COMPENSATION… more
    Mass Markets (08/21/25)
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  • Spanish Licensed Health Insurance Agent

    Mass Markets (NM)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and...are not allowed for accessing the client's Work at Home systems. + You must provide your own headset.… more
    Mass Markets (08/18/25)
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  • Telephone Sales Agent (Hiring Immediately)

    Mass Markets (Las Cruces, NM)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,...support in a contact center environment + Work at home experience + State or Federal work experience COMPENSATION… more
    Mass Markets (07/16/25)
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  • Vice President, Strategic Accounts

    Evolent (Santa Fe, NM)
    …customer accounts + Strong knowledge of health plan operations, care/utilization management, claims processing , value-based care, and the levers to optimize ... Solutions, Strategic Accounts, Analytics, Client Finance, Implementation, Clinical Operations, Medical , Quality, and Call Center Teams) to identify new… more
    Evolent (08/27/25)
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