• Medical Claims Processor…

    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 + ... a variety of business operations. We are seeking **Fully Remote US Based** Claims Processors to join...Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the… more
    Cognizant (08/26/25)
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  • Medical Claims Adjudication…

    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
    Cognizant (08/01/25)
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  • 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 |...medical , dental vision, 401K on day one. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable… more
    Sedgwick (08/23/25)
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  • Claims Examiner | General Liability…

    Sedgwick (Santa Fe, NM)
    …Financial Services & Insurance Claims Examiner | General Liability Property Damage | Remote As a Claims Examiner at Sedgwick, you'll have the opportunity to ... daily work and your career path. This is a remote , work-at-home, telecommuter position. + Be a part of...CANDIDATE?** If you have experience as a **General Liability Claims Examiner involving property damage in residential construction** and… more
    Sedgwick (08/27/25)
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  • 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 (08/26/25)
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  • 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)
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  • Senior Examiner, Claims ( Remote )

    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
    Molina Healthcare (08/27/25)
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  • 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 ... including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery,… more
    Molina Healthcare (07/18/25)
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  • Examiner, Claims ( Remote )

    Molina Healthcare (Roswell, NM)
    …to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . + Manages a caseload of claims ... **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls...claim records. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in… more
    Molina Healthcare (08/27/25)
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  • 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)
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