Hub International InsuranceClaims Advisor - Commercial Insurance Hub International InsuranceClaims Advisor - Commercial InsuranceAlbuquerque, New MexicoWith more than 650 offices and over 22,000 employees across North America, we are committed to helping individuals and businesses evaluate and manage their risks and insurance needs with personalized service, while our dedicated team delivers expert guidance and tailored solutions to ensure superior customer experience and lasting value for our clients. The Claims Advisor delivers proactive communication, maintains detailed file documentation, analyzes claim trends, and supports clients throughout the full lifecycle of their claims to ensure a smooth, informed, and efficient claims experience.
Hub International LtdClaims Advisor - Commercial Insurance Hub International LtdClaims Advisor - Commercial InsuranceAlbuquerque, NMWith more than 650 offices and over 22,000 employees across North America, we are committed to helping individuals and businesses evaluate and manage their risks and insurance needs with personalized service, while our dedicated team delivers expert guidance and tailored solutions to ensure superior customer experience and lasting value for our clients. The Claims Advisor delivers proactive communication, maintains detailed file documentation, analyzes claim trends, and supports clients throughout the full lifecycle of their claims to ensure a smooth, informed, and efficient claims experience.
TriWest Healthcare AllianceClaims Reviewer TriWest Healthcare AllianceClaims ReviewerAlbuquerque, NMRemoteFull timeProficient with claim and coding tools and resources, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and/or the Claims Subcontractor as needed.
GallagherSenior Workers Compensation Claims Adjuster GallagherSenior Workers Compensation Claims AdjusterAlbuquerque, New MexicoRemote
GallagherSenior Workers Compensation Claims Adjuster - NM GallagherSenior Workers Compensation Claims Adjuster - NMAlbuquerque, New MexicoRemote
TriWest Healthcare AllianceSupervisor, Claims Admin TriWest Healthcare AllianceSupervisor, Claims AdminAlbuquerque, NMRemoteFull timeThe Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
TriWest Healthcare AllianceSr Claims Reviewer TriWest Healthcare AllianceSr Claims ReviewerAlbuquerque, NMRemoteFull timeProficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.
Albuquerque Public SchoolsJUNIOR CLAIMS ADJUSTER Albuquerque Public SchoolsJUNIOR CLAIMS ADJUSTERAlbuquerque, NMfor more description visit this url : https://hrd.aps.edu/workspace/wSpace.exe? Action=wsJobsDetail&JobPosting=00068657.
CCMSIWorkers' Compensation Claim Specialist CCMSIWorkers' Compensation Claim SpecialistAlbuquerque, New MexicoRemote$70,000–$85,000 / yearResponsibilities: When we hire Workers’ Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust. Given the nature of the caseload, this position also requires experience managing litigated claims and working closely with legal counsel, including preparing cases for hearings or trial and participating in key legal proceedings.
CCMSIWorkers' Compensation Claim Representative I CCMSIWorkers' Compensation Claim Representative IAlbuquerque, New Mexico$55,000–$60,000 / yearResponsibilities: When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person’s livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems. At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
MindlanceUtilization Review Nurse (LPN) MindlanceUtilization Review Nurse (LPN)Albuquerque, NMRemoteReview Service Requests, Collect Clinical And Non-Clinical Data, Verify Eligibility, Determine Benefit Levels In Accordance To Contract Guidelines, Conducting Initial And Concurrent Review, Prepare Reports On Quality Of Care, Identify And Report Cases, And Provide Information Regarding Utilization Management Requirements And Operational Procedures To Members, Providers And Facilities. This Position Is Responsible For Performing Discharge Care Coordination And Review Activities For Determining Efficiency, Effectiveness And Quality Of Medical/Surgical Services And Serving As Liaison Between Providers And Medical And Network Management Divisions.
Health Care Service CorpNewProvider Specialist (Remote) Health Care Service CorpProvider Specialist (Remote)Albuquerque, NMRemote$17.75–$28.39 / hourThis Position Is Responsible For Loading Providers Into The Ihscps System Understanding Center For Medicare Services Reimbursement At A National Level For Inpatient, Outpatient, Professional And Ancillary Services And Being Able To Interpret Indian Health Services Contract Language To Correctly Create The Pricing In The Ihscps System For Each Contract Testing All Projects That Could Impact Or Involve The Pricing Methodologies. Function as subject matter expert (SME) on provider and pricing files for the IHS Operations Units, and train any new provider payment specialist or level 2 provider payment clerk in tasks related to provider, contract, pricing or legal entity files.
American Dental CompaniesDental Front Office Coordinator - Parkway Dental American Dental CompaniesDental Front Office Coordinator - Parkway DentalAlbuquerque, NMJoin us at Parkway Dental where we value teamwork, patient care, and continuous improvement. - Greet patients with a warm smile and assist with check-in and check-out processes.
Health Care Service CorpProvider Relations Coordinator HYBRID/FLEX Health Care Service CorpProvider Relations Coordinator HYBRID/FLEXAlbuquerque, NM$38,100–$80,000 / yearMaintain accurate and timely documentation within Salesforce, ensuring all provider interactions, outreach activities, issue resolution, and key relationship management details are consistently recorded and updated to support business operations, reporting, and performance tracking. Bachelors degree and one year of managed care experience in products or contracts OR 3 years direct experience in a managed care environment with one year experience in claims, pricing, products, regulatory compliance or contracts.
United States Air ForceSAFETY AND OCCUPATIONAL HEALTH SPEC (PILOT) United States Air ForceSAFETY AND OCCUPATIONAL HEALTH SPEC (PILOT)Kirtland AFB, NM$107,592–$139,871 / yearExamples of specialized experience includes applying knowledge of the theories, principles and practices of fighter aircraft flight safety and technical safety to sufficiently provide leadership at the national level in the development of aviation specific safety processes and trend analysis; broad range of aviation safety requirements to sufficiently plan, direct, coordinate and manage mishap investigations to help identify actionable solutions. Tax Law Impact for PCS: On 22-Dec-2017, Public Law 115-97 - the "Tax Cuts and Jobs Act of 2017" suspended qualified moving expense deductions along with the exclusion for employer reimbursements and payments of moving expenses effective 01-Jan-2018 for tax years 2018 through 2025.
Presbyterian Healthcare ServicesRevenue Recovery Specialist I-Patient Accounting-ABQ Presbyterian Healthcare ServicesRevenue Recovery Specialist I-Patient Accounting-ABQNMResponsibilities: Primarily responsible for working in the payment variance work queue to identify payer specific trends and reports significant and recurring issues to the Revenue Recovery Specialist II. Founded in New Mexico in 1908, we are the states largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
UNM Medical Group, Inc.Account Operations Tech 1 UNM Medical Group, Inc.Account Operations Tech 1Albuquerque, NMPerforms a variety of routine day-to-day operations related to the administration of billing accounts for a defined University medical service or billing agent. We ASPIRE to incorporate the following values into all aspects of our culture and work: we always demonstrate an Attitude of Service with Positivity, Integrity and Respect as we strive for Excellence.
Health Care Service CorpAudit Specialist II Health Care Service CorpAudit Specialist IIAlbuquerque, NMRemote$41,700–$92,800 / yearThis role requires advanced knowledge of Affordable Care Act, Commercial, Medicare and Medicaid reimbursement methodologies, including facility, ancillary, and professional claims, as well as the ability to analyze claim calculations, interpret provider contracts, collaborate with cross-functional teams, and identify opportunities to improve audit accuracy, compliance, and operational performance. The Audit Specialist Analyst II is responsible for independently executing internal and external audits, interpreting audit findings, validating compliance with contractual performance guarantees, and supporting broader quality assurance initiatives.
Presbyterian Healthcare ServicesCall Center Representative-Hospital location Presbyterian Healthcare ServicesCall Center Representative-Hospital locationPresbyterian Hospital, NMIncludes operating several computer programs relating to dispatch and alarm systems by following established emergency procedures as assigned by department to maintain clear and concise communication with appropriate teams and clinical staff. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Fluent HealthCall Center Representative-Hospital location Fluent HealthCall Center Representative-Hospital locationAlbuquerque, New MexicoIncludes operating several computer programs relating to dispatch and alarm systems by following established emergency procedures as assigned by department to maintain clear and concise communication with appropriate teams and clinical staff. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
U.S. Department of Veterans AffairsSupervisory Veterans Service Representative (Coach) U.S. Department of Veterans AffairsSupervisory Veterans Service Representative (Coach)Albuquerque, NM$107,592–$139,871 / yearThe Supervisory Veterans Service Representative (Coach) leads an assigned team within the Veterans Service Center (VSC), BEST, or Pension Management Center division through a staff of personnel responsible for providing information, advice, and assistance on all types of Veterans benefits claims administered to veterans and their dependents and for providing outreach services to various stakeholders. Volunteer Experience: Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social).
Molina Healthcare IncMedical Review Nurse -UM/Post Appeals (Michigan RN license req) Molina Healthcare IncMedical Review Nurse -UM/Post Appeals (Michigan RN license req)Rio Rancho, NMREQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical review), medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.
US Department of Health and Human ServicesContact Representative (Benefits Coordinator) US Department of Health and Human ServicesContact Representative (Benefits Coordinator)Bernalillo, NM$45,409–$72,644 / yearGS-08: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: interpreting and applying federal, state, Tribal, and third-party program regulations to determine eligibility and ensure compliance for programs such as Purchase Referred Care, Medicare, Medicaid, Affordable Care Act, Veterans Affairs Healthcare, and other alternate resources; conducting in-depth patient interviews to assess eligibility, verify coverage, and complete applications; registering eligible patients in various assistance programs; resolving claim denials and eligibility issues through coordination with patients, healthcare providers, and outside agencies; reviewing Medicaid eligibility information and supporting billing requirements; and utilizing effective oral and written communication to explain program requirements, provide referrals, and resolve complex patient service issues. MINIMUM QUALIFICATIONS: GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: determining patient eligibility for alternate resources programs; interpreting and applying Medicare, Medicaid, VA, and other third-party payer policies and procedures; conducting patient interviews to identify available healthcare coverage and funding sources; assisting patients with enrollment and claims processes; researching and resolving eligibility, denial, and reimbursement issues; maintaining effective working relationships with patients and resource agencies; and safeguarding confidential patient information in accordance with Privacy Act and HIPAA requirements.
SaiaCustomer Care Specialist SaiaCustomer Care SpecialistAlbuquerque, New MexicoRead, write, communicate and comprehend the English language in order to perform the various tasks of the job, including but not limited to: converse with co-workers and members of the general public, including customers; understand oral and written instructions as well as governmental regulations; respond to questions and inquiries from management and government representatives; and accurately complete various documents, reports and records required of the position. Delivers escalated support to customers while working closely with terminal operations to resolve disputes, scheduling conflicts, and service concerns.
TriWest Healthcare AllianceIT Delivery Lead TriWest Healthcare AllianceIT Delivery LeadAlbuquerque, NMRemoteFull timeTechnical Skills: Knowledge of technology impacts on business strategic direction enabling definition and integration of technical plans supporting the enterprise business functions; knowledge and expertise in project/program management methodologies and tools to include Agile; experience with product/solution/system lifecycles; expert knowledge in one or more of: system servers and data network; traditional telephony principals and support; Microsoft enterprise software, server principals and support; HP enterprise products and services: data communication and network architectures, design, and support; installation, maintenance and support of large scale application systems; healthcare industry experience, to include medical management and provider data/solutions: proficient with Microsoft Project, Project Server, Visio, and SharePoint Services. • 7+ years of related and progressive experience combining various elements of technical delivery or support, solutions implementation, process automation, project management, and team leadership .
TriWest Healthcare AllianceDirector, Provider Experience TriWest Healthcare AllianceDirector, Provider ExperienceAlbuquerque, NMRemoteFull timeThe Director ensures the delivery of exceptional service to providers and government stakeholders by directing cross-functional programs that enhance provider satisfaction, strengthen network engagement, and uphold contractual and regulatory compliance. Coaching / Training / Mentoring: Actively develops the skills and capabilities of direct reports and extended team members through constructive feedback, mentoring relationships, and structured development opportunities aligned with business outcomes.
TriWest Healthcare AllianceProvider Relations Rep TriWest Healthcare AllianceProvider Relations RepAlbuquerque, NMRemoteFull timeTechnical Skills: The ability to solve problems independently while working in a fast paced, energetic environment; strong communication skills, (oral and writing skills); a proven ability as a facilitator/instructor; self-motivated, able to work in a team and independently. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.
Presbyterian Healthcare ServicesPFS Billing Specialist I-ABQ Presbyterian Healthcare ServicesPFS Billing Specialist I-ABQAlbuquerque, NMAll benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Summary: Accurately submit all insurance claims, for all payer types, including Government payers within claims clearinghouse application and patient accounting system.
Commonwealth Medical ServicesNurse Practitioner - Albuquerque, NM - Full Time Commonwealth Medical ServicesNurse Practitioner - Albuquerque, NM - Full TimeAlbuquerque, NMWho We’re Looking For: Whether you’re a new graduate looking to kickstart your career or an experienced provider seeking a slower, more flexible pace, this role is for you! We offer competitive guaranteed pay, a supportive environment, and the flexibility you’ve been looking for.
Commonwealth Medical ServicesNurse Practitioner - (Part-Time) - Albuquerque, NM Commonwealth Medical ServicesNurse Practitioner - (Part-Time) - Albuquerque, NMAlbuquerque, NMJoin a provider-led organization that puts clinicians first—while allowing you to make a meaningful impact serving our nation’s Veterans. Why This Role is Different: Skip the uncertainty of per-exam contracting and enjoy a 1099 position with guaranteed income and built-in support.
MADISON INSURANCE GROUP, INC.MVD Clerk MADISON INSURANCE GROUP, INC.MVD ClerkAlbuquerque, NMKey Responsibilities: Fingerprinting: Fingerprint the public for MVD; TSA Prescreen, registrations, driver license finger printing, and state required fingerprinting. The ideal candidate is a proactive communicator dedicated to providing exceptional service and building long-term client relationships.
UNM Medical Group IncAccount Operations Tech 1 UNM Medical Group IncAccount Operations Tech 1Albuquerque, NMSummary: Performs a variety of routine day-to-day operations related to the administration of billing accounts for a defined University medical service or billing agent. We ASPIRE to incorporate the following values into all aspects of our culture and work: we always demonstrate an Attitude of Service with Positivity, Integrity and Respect as we strive for Excellence.
Walmart IncFreezer, Cooler and Deli Stocker Associate Walmart IncFreezer, Cooler and Deli Stocker AssociateAlbuquerque, NM$16–$23 / hourMaintains the Sales Floor and merchandise presentation in the Freezer/Cooler/Deli area in accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking merchandise; setting up, cleaning, and organizing product displays; removing damaged goods; signing and pricing merchandise appropriately; completing required audits, paperwork, logs, and other required documentation; and securing fragile and high-shrink merchandise. Follows Company policies and procedures related to Freezer/Cooler area by complying with food handling policies; operating, repairing, and sanitizing equipment; following Cold Chain procedures when stocking merchandise; cleaning freezer /cooler/deli area (for example, windows, mirrors, display cases and coolers); monitoring freezer/cooler fans, drains and doors for proper operation; and reporting issues to Management.
Walmart Inc(USA) Optician Sam''''''''s Walmart Inc(USA) Optician Sam''''''''sALBUQUERQUE, NM$17–$25 / hourSells Optical products and services by assisting Members with purchasing decisions measuring adjusting and repairing frames and lenses completing eyewearcontact lens orders identifying and verifying prescription information completing and maintaining paperwork forms and other required documentation collecting payments for doctor services and performing and recording results of optometric pretests. Respect the Individual: Embraces differences in people cultures ideas and experiences creates a workplace where associates feel seen supported and connected through a culture of belonging creates opportunities for all associates to thrive and perform helps to attract the best talent.
Walmart IncOptician Sam''''''''s Walmart IncOptician Sam''''''''sALBUQUERQUE, NM$17–$25 / hourSells Optical products and services by assisting Members with purchasing decisions measuring adjusting and repairing frames and lenses completing eyewearcontact lens orders identifying and verifying prescription information completing and maintaining paperwork forms and other required documentation collecting payments for doctor services and performing and recording results of optometric pretests. Respect the Individual: Embraces differences in people cultures ideas and experiences creates a workplace where associates feel seen supported and connected through a culture of belonging creates opportunities for all associates to thrive and perform helps to attract the best talent.
Rachel Bloom - State Farm AgentCustomer Service Representative - State Farm Agent Team Member Rachel Bloom - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberAlbuquerque, NMAs a Customer Service Representative - State Farm Agent Team Member with Rachel Bloom - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Presbyterian Healthcare ServicesPatient Accounting Denials Specialist I Presbyterian Healthcare ServicesPatient Accounting Denials Specialist INMExcellent organizational, problem-solving, verbal, and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams are required. All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Rick Buckner - State Farm AgentCustomer Service Representative - State Farm Agent Team Member Rick Buckner - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberAlbuquerque, NMWe also take pride in helping to educate our customers on all aspects of the policies the customer has chosen giving them a clear understanding of what their coverages means not just selling them a product. As a Customer Service Representative with Rick Buckner State Farm, you will generate the kind of exceptional customer experiences that reinforces the growth of a successful insurance agency.
Carlos Salazar - State Farm AgentCustomer Service Representative - State Farm Agent Team Member Carlos Salazar - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberAlbuquerque, NMAs a Customer Service Representative - State Farm Agent Team Member with Carlos Salazar - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Rigo Castillo-Sanchez - State Farm AgentInsurance Account Position - State Farm Agent Team Member Rigo Castillo-Sanchez - State Farm AgentInsurance Account Position - State Farm Agent Team MemberAlbuquerque, NMROLE DESCRIPTION: Rigo Castillo-Sanchez State Farm Agency is searching for a competitive Producer who can recognize opportunities and strategically turn leads into long-lasting customer relationships. As our Sales rep, your knowledge of insurance products and industry trends equips you to communicate directly with customers, identify their needs, and market products or services that maximize value.
AtkinsRealis Group IncSite Inspector AtkinsRealis Group IncSite InspectorAlbuquerque, NM$30–$35 / hourNote to staffing and direct hire agencies: In the event a recruiter or agency who is not on our preferred supplier list submits a resume/candidate to anyone in the company, AtkinsRéalis family of companies, we explicitly reserve the right to recruit and hire the candidate(s) at our discretion and without any financial obligation to the recruiter or agency. This project is part of a major federal effort supporting the FEMA Hermit's Peak / Calf Canyon Claims Office, which was established to compensate New Mexico residents impacted by the Hermit's Peak and Calf Canyon wildfires and subsequent floods.
Paul Gallegos - State Farm AgentCustomer Service Representative - State Farm Agent Team Member Paul Gallegos - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberAlbuquerque, NMAs a Customer Service Representative - State Farm Agent Team Member with Paul Gallegos - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. Over the years, our team has supported local high school athletes, partnered with food banks, donated to shelters, and provided school supplies to those in need.
Theresa Saiz-Wilmert - State Farm AgentCustomer Service Representative - State Farm Agent Team Member Theresa Saiz-Wilmert - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberAlbuquerque, NMAs a Customer Service Representative - State Farm Agent Team Member with Theresa Saiz-Wilmert - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Erin Carnett - State Farm AgentCustomer Service Representative - State Farm Agent Team Member Erin Carnett - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberAlbuquerque, NMAs a Customer Service Representative - State Farm Agent Team Member with Erin Carnett - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Kathlein Guinn - State Farm AgentCustomer Service Representative - State Farm Agent Team Member Kathlein Guinn - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberAlbuquerque, NMAs a Customer Service Representative - State Farm Agent Team Member with Kathlein Guinn - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Health Care Service CorpNewSr Network Management Consultant - Work from Home Health Care Service CorpSr Network Management Consultant - Work from HomeAlbuquerque, NM$61,500–$136,100 / yearThis position is responsible for small to mid-size provider recruitment and contracting activities for physicians, physician groups and facilities (independent hospitals, independent physicians with negotiations, small group / IPAs, etc). Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.
Health Care Service CorpManager - System Pricing - Work From Home Health Care Service CorpManager - System Pricing - Work From HomeAlbuquerque, NM$92,700–$167,500 / yearThis position is responsible for coordinating research and developing new facility pricing methodologies and/or new facility types/specialties; recommending, initiating or writing appropriate System Change requests (SCRs); verifying testing results and approved changes for production; providing documentation and training associated with the pricing system and changes or modifications; interfacing with divisions which impact the pricing aspects of the claims processing system; ensuring files are constructed and maintained; and coordinating activities with Service Unit and Network Management to ensure accurate and consistent claim pricing. Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.