- Humana (Santa Fe, NM)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Santa Fe, NM)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Ryder System (Santa Fe, NM)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Sedgwick (Albuquerque, NM)
- …Fortune Best Workplaces in Financial Services & Insurance Quality Control Representative - Heavy Equipment/Specialty **PRIMARY PURPOSE:** The Quality Control ... Representative ensures accuracy, consistency, and compliance in Specialty claim...continuous improvement across teams. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Review claim files for completeness, accuracy, and adherence to… more
- Mass Markets (Las Cruces, NM)
- POSITION OVERVIEW TECHNICAL SUPPORT REPRESENTATIVE (FULL-TIME) As a technical support representative , you will handle blended inbound phone interactions with ... issues when needed + Accurately document and process customer claims in appropriate systems + Utilize knowledge base and...resolution as needed + Attend meetings and training and review all new training material to stay up-to-date on… more
- Mass Markets (Las Cruces, NM)
- POSITION OVERVIEW CABLE SALES REPRESENTATIVE (FULL-TIME) The sales job of the year is now hiring! We are looking for sales agents to support a national cable service ... account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,...effective call handling + Attend meetings and training and review all new training material to stay up to… more
- Mass Markets (Las Cruces, NM)
- POSITION OVERVIEW CUSTOMER CARE REPRESENTATIVE JOB OPENINGS We are looking for customer care representatives to support projects for a wide variety of clients. You ... issues when needed + Accurately document and process customer claims in appropriate systems + Utilize knowledge base and...resolution as needed + Attend meetings and training and review all new training material to stay up-to-date on… more
- Mass Markets (Las Cruces, NM)
- POSITION OVERVIEW ENERGY CUSTOMER CARE REPRESENTATIVE (FULL-TIME) Here at MCI, we keep things light. We believe our customer service representatives are at their ... account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,...effective call handling + Attend meetings and training and review all new training material to stay up-to-date on… more
- Mass Markets (Las Cruces, NM)
- POSITION OVERVIEW COLLECTIONS REPRESENTATIVE JOB OPENINGS Join our team and grow with us! We need collections representatives to respectfully recover past due ... goals and perform other assigned duties + Attend meetings and training and review all new training material to stay up-to-date on changes to program knowledge,… more
- Mass Markets (Las Cruces, NM)
- POSITION OVERVIEW PHONE SALES REPRESENTATIVE JOB OPENINGS We are looking for phone sales representatives to support a variety of projects while representing some of ... staff and managerial for resolution as needed + Attend meetings and training and review all new training material to stay up-to-date on changes to program knowledge,… more
- Mass Markets (Las Cruces, NM)
- …to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures ... through problems solving and effective call handling + Attend meetings and training and review all new training material to stay up to date on changes to program… more
- Mass Markets (NM)
- …to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures ... through problems solving and effective call handling + Attend meetings and training and review all new training material to stay up to date on changes to program… more
- Interior, Bureau of Indian Affairs (San Juan Pueblo, NM)
- …development of Case Plans or Individual Self-Sufficiency Plans (ISP). Interview, review resources, and determine eligibility of clients applying for Financial ... services to clients and/or assist social workers; process client applications, review referrals and service requests; perform program automated data processing… more
- Highmark Health (Santa Fe, NM)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Ryder System (Santa Fe, NM)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Highmark Health (Santa Fe, NM)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- CVS Health (Santa Fe, NM)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- Prime Therapeutics (Santa Fe, NM)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- RxBenefits (Albuquerque, NM)
- …team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting. The successful Pharmacy Pricing Senior Manager will ... across internal stakeholders to foster collaborative and efficient work products + Review for accuracy and finalize all current account pricing comparisons for… more