Claims Processing Jobs in Albuquerque, NM

OverviewPresbyterian is seeking a Manager - EVV and LTS Support. This position will be responsible for the oversight of the Electronic Visit Verification (EVV) program and Long Term Services and Supports (LTSS). Requires attention to detail and strong communication skills to adequately represent the...

OverviewPresbyterian is seeking a Pharmacy Member Experience SpecialistA Pharmacy Member Experience Specialist performs as a Presbyterian Pharmacy Services representative and as a Service Recovery Specialist and is responsible for providing customer service for members and providers for all PHP bene...

OverviewThe Director of Claims and Encounters provides strategic leadership fiscal accountability and operational excellence for the Presbyterian Health Plan (PHP) Claims Operations and Encounter Resolution teams. This leader is responsible for directing the operations of the Claims Department for C...

OverviewNow hiring Call Center Representative-Hospital locationServes as a 24/7 central communication center ensuring all routine moderate complex and emergent customer requests are answered and routed to the appropriate department in a timely manner. Responds immediately to critical patient care co...

OverviewPresbyterian is seeking a Manager - Provider Network Operations.The person in this position will ensure the integrity of provider service contracting development of new networks. Build and maintain strong relationships with providers to foster collaboration and improve communication. Educate...

Ignite your potential. Impact what matters.Hi were HUB were more than an insurance broker were a network of doers with diverse stories and a shared goal: to support our clients and communities. Great work happens when people come together which is why we build teams where every voice is valued ide...

OverviewThe Director of Claims and Encounters provides strategic leadership fiscal accountability and operational excellence for the Presbyterian Health Plan (PHP) Claims Operations and Encounter Resolution teams. This leader is responsible for directing the operations of the Claims Department for C...

OverviewPresbyterian is seeking a Clinical Pharmacy Review SpecialistThe Clinical Pharmacy Review Specialist works under the direct supervision of a Clinical Pharmacist within the Pharmacy Services Department.This position is responsible for providing clinical support for the Health Pharmacy Service...

AMERIND is a federally chartered tribally owned corporation formed under Section 17 of the Indian Reorganization Act (25 U.S.C. 5124) by its Members the governmental units of federally recognized Tribal Nations that administer federally funded housing programs for American Indian and Alaska Native...

OverviewPresbyterian is seeking a Provider Enrollment Coordinator to process health plan payer provider enrollment applications for all PHS system-wide employed or contracted healthcare providers as needed. Along with the Provider Enrollment Manager directs the PHS system wide provider enrollment pr...

Chrysalis Psychiatry is a growing outpatient mental health practice in Albuquerque New Mexico. We offer a variety of mental health services including medication management and interventional treatments for PTSD depression and other mental illnesses. We are looking for a highly motivated strategic th...

OverviewThe Payment Accuracy Recovery Analyst is responsible for identifying validating and recovering improper payments across medical claims and provider reimbursements. This role owns enterprise-wide payment integrity initiatives by analyzing claims data collaborating with internal and external s...

OverviewThis position will be responsible for the oversight of Long Term Services and Supports (LTSS). Requires attention to detail and strong communication skills to adequately represent the organization at conferences and speak in front of an audience. Will be responsible for the long term care te...