- Highmark Health (Santa Fe, NM)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Molina Healthcare (Albuquerque, NM)
- JOB DESCRIPTION **Job Summary** Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** * Serves as … more
- Highmark Health (Santa Fe, NM)
- …SUMMARY** This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a ... product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements.… more
- Rocket Software (Santa Fe, NM)
- …people truly BELIEVE in what they're doing!** **Job Description Summary:** The Senior Benefit Analyst is responsible for building and delivering both global and ... country programs in line with the global total rewards philosophy. The Senior Benefits Analyst supports the design, administration, and analysis of Americas' and… more
- Public Consulting Group (Santa Fe, NM)
- …To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative tasks and the entire claim ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …benefits . Come discover more about Otsuka and our benefit offerings; https://www.otsuka-us.com/careers-join-otsuka . **Disclaimer:** This job description is ... can too._ In this exciting role, as a Sr. Analyst within OAPI supply chain team, you will work...posted for a minimum of 5 business days. **Company benefits :** Comprehensive medical, dental, vision, prescription drug coverage, company… more
- Molina Healthcare (Rio Rancho, NM)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... system requirements of customers as it pertains to contracting, benefits , prior authorizations, fee schedules, and other business requirements.… more
- Cognizant (Santa Fe, NM)
- **Job Summary:** We are seeking a strong Duck Creek Functional Analyst / Business Analyst to work closely with customer Product Owners. The ideal candidate will ... teams to handle queries and understand requirements. . Experience with Billing and Claims configuration knowledge and Data Insight producer policy holder is an added… more
- Humana (Santa Fe, NM)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- Prime Therapeutics (Santa Fe, NM)
- …pricing or financial analysis to include 5 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field** **3 ... build the future of pharmacy with us. **Job Posting Title** Principal Pricing Analyst - REMOTE **Job Description** **The Principal Pricing Analyst leads complex… more