• Claims Examiner - Workers Compensation…

    Sedgwick (Santa Fe, NM)
    …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation REMOTE |... within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting… more
    Sedgwick (08/23/25)
    - Related Jobs
  • Claims Processor (with Facets) - Healthcare…

    Cognizant (Santa Fe, NM)
    …+ 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. + Must ... Based on this role's business requirements, this is a remote position open to qualified applicants in the United...ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:**… more
    Cognizant (08/22/25)
    - Related Jobs
  • Claims Examiner Workers Comp…

    Sedgwick (Santa Fe, NM)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner Workers Comp I Remote I SE, Central, NE regions **PRIMARY ... PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving… more
    Sedgwick (06/29/25)
    - Related Jobs
  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (Rio Rancho, NM)
    …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... and IPA. + 2 years supervisory/management experience with appeals/grievance and/or claims processing within a managed care setting. **Preferred Education**… more
    Molina Healthcare (07/18/25)
    - Related Jobs
  • Medical Claims Adjudication - remote

    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 ... + 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. + Excellent… more
    Cognizant (08/01/25)
    - Related Jobs
  • Remote - Claims Adjuster…

    Reynolds & Reynolds (Albuquerque, NM)
    Position Description * This is a full-time, remote position working from 9:45am to 6:15pm CSTAmerican Guardian Warranty Services, Inc. (AGWS), an affiliate of ... Reynolds and Reynolds, is seeking Claims Adjuster - Automotive for our growing team. In...are not limited to:-\tAnswering inbound calls-\tProvide information about claim processing and explain the different levels of contract coverage… more
    Reynolds & Reynolds (07/03/25)
    - Related Jobs
  • Lead Analyst, Configuration Oversight - Payment…

    Molina Healthcare (NM)
    …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... of Benefits (COB) claim pricing and processing . This role will focus on identifying, reviewing, and...guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen.… more
    Molina Healthcare (07/24/25)
    - Related Jobs
  • French Speaking Desk Adjuster - Remote

    Sedgwick (Santa Fe, NM)
    …in Financial Services & Insurance French Speaking Desk Adjuster - Remote **_Bilingual/French Speaking Desk Adjuster_** **PRIMARY PURPOSE** **:** Handles losses and ... claims valued up to $15,000 for property and casualty...manages a case load using technology for efficient claim processing . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Evaluates insurance policies,… more
    Sedgwick (06/29/25)
    - Related Jobs
  • Lead Specialist, Appeals & Grievances…

    Molina Healthcare (Las Cruces, NM)
    …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
    Molina Healthcare (08/24/25)
    - Related Jobs
  • Specialist, Appeals & Grievances - Remote

    Molina Healthcare (Roswell, NM)
    …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
    Molina Healthcare (08/24/25)
    - Related Jobs