- Molina Healthcare (Roswell, NM)
- **JOB DESCRIPTION** **Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains ... claims databases. Synchronizes data among operational and claims systems and application of business rules as they...execution of some test plans. + Participates in the implementation and conversion of new and existing health plans.… more
- Humana (Santa Fe, NM)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... The Senior Business Intelligence Engineer will be primarily responsible for implementation , maintenance and support of Medicaid provider reimbursement for hospitals… more
- Molina Healthcare (Roswell, NM)
- **JOB DESCRIPTION** **Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains ... claims databases. Synchronizes data among operational and claims systems and application of business rules as they...execution of some test plans. + Participates in the implementation and conversion of new and existing health plans.… more
- Prime Therapeutics (Santa Fe, NM)
- …passion and drives every decision we make. **Job Posting Title** Principal Benefit Analyst - REMOTE **Job Description** The Principal Benefit Analyst is ... **Responsbilities** + Manage annual renewal process, including analyze plan utilization, claims and health trends, model plan cost and design options, and… more
- Molina Healthcare (Las Cruces, NM)
- **JOB DESCRIPTION** **Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains ... claims databases. Synchronizes data among operational and claims systems and application of business rules as they...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Molina Healthcare (Rio Rancho, NM)
- **JOB DESCRIPTION** **Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains ... claims databases. Synchronizes data among operational and claims systems and application of business rules as they...execution of some test plans. + Participates in the implementation and conversion of new and existing health plans.… more
- Molina Healthcare (Roswell, NM)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... development and execution of some test plans. + Participates in the implementation and conversion of new and existing health plans. **JOB QUALIFICATIONS** **Required… more
- Healthfirst (NM)
- …(PBM) + Monitors and analyzes key data and procedures for proper claims processing and adjudication system functionality + Performs Quality Control and Quality ... benefit + Provides timely support to other areas to verify and analyze claims processing cases, eligibility and other operational situations and/or issues as they… more
- TXNM Energy (Albuquerque, NM)
- …SUMMARY: Manages the corporate insurance function, including insurance structuring and implementation of financial risk transfer mechanisms. . ESSENTIAL DUTIES AND ... of various insurance and brokerage contracts Manages self-insurance program, claims , litigations, reserves, and allocation processes Oversees the processes to… more