- CVS Health (Santa Fe, NM)
- …each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. They ... identifying errors, necessary corrective measures, and may participate in special audit assignments. **Required Qualifications** + 1+ years of experience working in… more
- Health Care Service Corporation (Albuquerque, NM)
- …in your professional development. **Job Summary** The Advanced Contract Specialist is responsible for developing master documents and/or account-specific financial ... processes, update provider demographic information, and pull contracts for legal, audit , and compliance purposes. **Required Job Qualifications:** + 4 years… more
- Molina Healthcare (Albuquerque, NM)
- …following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare ... of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more