- GE Aerospace (Santa Fe, NM)
- …of medical terminology and medical impairments related to long term care, disability, life and/or health insurance claims + Note: Position can be hybrid or ... + Provide ongoing support and input to clients regarding claim accuracy and fraud mitigation practices, as appropriate +...years (3) of experience in reinsurance, auditing and/or adjudicating insurance claims . + Ability to query and… more
- Ryder System (Santa Fe, NM)
- …years or more experience in employment law. + Experience managing employment claims raised with federal and/or state administrative agencies. **SKILLS & ATTRIBUTES** ... Information** : **For all Full-time positions only** : Ryder offers comprehensive health and welfare benefits, to include medical, prescription, dental, vision, life… more
- Molina Healthcare (Las Cruces, NM)
- …information + Ability to maintain confidentiality and to comply with Health Insurance Portability and Accountability Act (HIPAA) **PROGRAM REQUIREMENTS:** ... supervised learning and rule-based logic to detect potentially incorrectly paid claims . + Contribute to improve data quality, perform data audits, identify… more
- Mass Markets (NM)
- …success of a globally expanding, industry-leading organization. We are seeking aSpanish-speaking Licensed Health Insurance Agent. As a key member of our team, ... you will be responsible for providing exceptional service to clients, assisting with health insurance inquiries, and guiding customers through the process of… more
- Highmark Health (Santa Fe, NM)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... and servicing quality dental networks in assigned territory in a remote and mobile work environment. Manage network contracts including negotiations, contract… more
- Humana (Santa Fe, NM)
- … claims , and customer service). + Collaborate with each Insurance Operations function to identify, understand, and align Stars-related business strategies, ... + 8-9 + years of quality improvement, developing & advancing enterprise strategy, insurance operations experience, ie: claims , UM, CM, call center, enrollment,… more
- CVS Health (Santa Fe, NM)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...Proposal_ ) questionnaire responses, and plan consultation. This fully remote position will have the opportunity to work on… more
- Highmark Health (Santa Fe, NM)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... rates utilizing Company rating algorithms, adjusting accordingly to cover questionable claim patterns or unusual situations not otherwise contemplated within the… more
- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Molina Healthcare (Las Cruces, NM)
- …least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant ... in areas to ensure alignment to regulatory baseline requirements and any health plan/product team developed requirements. + Monitors regulatory sources to ensure all… more