- Cognizant (Santa Fe, NM)
- …a High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...guidelines and regulations + Experience in the analysis and processing of claims , utilization review/quality assurance procedures… more
- Concentrix (Santa Fe, NM)
- …a Customer Service Representative working from home, you will: + Provide customer support processing medical claims in a back-office setting + Help customers ... Job Title: Customer Service Representative-Remote (Healthcare Claims ) Job Description **JOB DESCRIPTION** The Customer Service Representative-Remote (Healthcare … 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
- CVS Health (Santa Fe, NM)
- …dollar amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, ... responsibilities. **Required Qualifications** + 2+ years of experience with medical claim processing . + 2+ years of...and interpersonal skills. + Previous experience with DG system claims processing . **Education** + Associate's degree or… 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
- Cognizant (Santa Fe, NM)
- …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... UB or HCFA paper or EDI information. + Evaluate medical records to determine if the service rendered was...of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality… more
- Molina Healthcare (NM)
- …**Required Education** High School or GED **Required Experience** 3-5 years claims processing required **Preferred Education** Bachelor's Degree or equivalent ... + Manages a caseload of various types of complex claims . Procures all medical records and statements...combination of education and experience **Preferred Experience** 5-7 years claims processing preferred To all current Molina… more
- Sedgwick (Santa Fe, NM)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting...medical , dental vision, 401K on day one. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable… more
- Sedgwick (Santa Fe, NM)
- …Coverage Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more