- Mass Markets (Las Cruces, NM)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... sometimes even cars! + Health Benefits:Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 60 days of employment, and all… more
- Humana (Santa Fe, NM)
- …- What it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, ... Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience… more
- Sedgwick (Santa Fe, NM)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Site Auto Appraiser (CAT Repair Solution) **PRIMARY PURPOSE** **:** To inspect, ... directly with auto repair facilities to determinate supplemental repair processing and provides a supplemental estimate. **ADDITIONAL FUNCTIONS and… more
- Humana (Santa Fe, NM)
- …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- UIC Government Services and the Bowhead Family of Companies (Chaparral, NM)
- …of Defense and many federal agencies. Bowhead offers competitive benefits including medical , dental, vision, life insurance , accidental death and dismemberment, ... required. + Extensive computer/PC knowledge required including; spreadsheet software, word processing software and knowledge of MS Office Suite. + Must be… more
- Guardian Life (Santa Fe, NM)
- …(LLMs), and Generative AI. + Apply AI/ML to unstructured data sources such as insurance contracts, medical records, sales notes, and customer service logs. + ... Guardian is on a transformation journey to evolve into a modern, forward-thinking insurance company committed to enhancing the wellbeing of its customers and their… more
- Ryder System (Santa Fe, NM)
- …limited to areas such as: I-9 compliance, Pre-employment services, Unemployment Insurance claims , Immigration Services, Leave Administration, Drug and Alcohol ... an hour. Ryder offers comprehensive health and welfare benefits, to include medical , prescription, dental, vision, life insurance and disability insurance… more
- Walgreens (Las Cruces, NM)
- …enhancements to pharmacy systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and ... prevent payment rejections. Follows-up with insurance companies as well as medical providers and participates in 3rd party audit. + Follows-up with medical … more
- 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
- Walgreens (Rio Rancho, NM)
- …to pharmacy errors and the Continuous Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and ... prevent payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. + Assists and… more