Non-Attorney Represented Bodily Injury Claims Adjuster - PST/MST (Remote) Allstate Insurance CompanyNon-Attorney Represented Bodily Injury Claims Adjuster - PST/MST (Remote)NMRemote$47,500–$61,600 / yearCase Management, Claims Administration, Claims Resolution, Claims Review, Customer Centricity, Customer Service, Digital Literacy, Inclusive Leadership, Insurance Claims Investigations, Learning Agility, Personal Injury Claims, Problem Solving, Results-Oriented, Time Management, Written Communication. As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment.
Financial Services Claims Adjuster Assurant IncFinancial Services Claims AdjusterNM$19.08–$30.53 / hourA Fortune 500 company with a presence in 21 countries, Assurant supports the advancement of the connected world by partnering with the world's leading brands to develop innovative solutions and deliver an enhanced customer experience through mobile device solutions, extended service contracts, vehicle protection services, renters insurance, lender-placed insurance products, and other specialty products. Named a Best/Great Place to Work in 14 countries and awarded the Fortune America's Most Innovative Companies recognition, we bring together top talent around the world.
Sr. Adjuster-Workers Comp Claims CopperPoint Insurance CoSr. Adjuster-Workers Comp ClaimsNMRemote$68,000–$98,500 / yearThe Workers' Compensation Claims Adjuster Senior, Indemnity is responsible for analyzing time loss workers' compensation claims to determine compensability. We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee's annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan).
Multi-Line Claims Adjuster - New Mexico Provencher & Company, LLCMulti-Line Claims Adjuster - New MexicoSanta Fe, NMWe excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations.
Director of Claims and Litigation Banner HealthDirector of Claims and LitigationNM$57.38–$95.64 / hourParticipates and presents at introductory meetings with potential insureds; prepares materials, participates and presents at Banner Medical Group (BMG) meetings, committees and other organizational structures and at other physician program meetings as established and as appropriate; provides education relative to the program across BH. Responsible for obtaining, entering data into claim file and monitoring such data in order to comply with deadlines for meeting Medicare, Medicaid, Ship Extension Act (MMSEA) reporting requirements in relation to claimants and others releasing medicals.
Claims Representative II - REMOTE Ryder System IncClaims Representative II - REMOTESanta Fe, NMRemoteCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( http://wd5.myworkday.com/ryder/d/task/1422$3.htmld ) to log in to Workday to apply using the internal application process.
Director of Complex Claims and Counsel Banner HealthDirector of Complex Claims and CounselNM$65.70–$109.50 / hourResponsible for obtaining, entering data into claim file and monitoring such data in order to comply with deadlines for meeting Medicare, Medicaid, Ship Extension Act (MMSEA) reporting requirements in relation to claimants and others releasing medical expense claims. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
Director Complex Claims and Counsel Banner HealthDirector Complex Claims and CounselNM$65.70–$109.50 / hourResponsible for obtaining, entering data into claim file and monitoring such data in order to comply with deadlines for meeting Medicare, Medicaid, Ship Extension Act (MMSEA) reporting requirements in relation to claimants and others releasing medical expense claims. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
Senior Claims Adjuster Trean Insurance Group IncSenior Claims AdjusterNM$75,000–$90,000 / yearEnsure that all claim determinations and payments are completed timely including but not limited to, acceptance/denial letters, wage determination letters including required enclosures and appeal forms. Timely claims determinations for all services including but not limited to: acceptance, denials, authorizations for treatment, benefit payment start, termination are to be included within the statutory or regulatory time frames of the jurisdiction.
Claims Analyst - REMOTE Ryder System IncClaims Analyst - REMOTESanta Fe, NMRemoteCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( http://wd5.myworkday.com/ryder/d/task/1422$3.htmld ) to log in to Workday to apply using the internal application process.
TEMP-Workers'''' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers'''' Compensation Claims AdjusterNMRemote$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Clearing the error involves researching to obtain the missing or misaligned information (sometimes requiring communication with the claimant or insured) and entering or correcting data in various fields in either our claims system or the state's reporting site.
Process Manager, Commercial Casualty Claims - Remote CSAA Insurance GroupProcess Manager, Commercial Casualty Claims - RemoteNMRemote$136,890–$152,100 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 21 more}. Project management experience and skills to accurately complete detailed data assignments and to understand and interpret broad operational concepts and their application to the business unit and CSAA.
Senior Analyst Claim Reporting and Special Services CVS Health CorpSenior Analyst Claim Reporting and Special ServicesNM$46,988–$112,200 / yearPosition Summary: We are looking for a highly motivated candidate who can effectively and accurately oversee and coordinate rework projects, work closely with other members of the Commercial Services Operations team providing project management, root cause analysis and precise resolution of affected claims. The candidate will serve as a Project Lead for rework projects/issues for a specific network or large-scale rework projects generated as a result of Plan Sponsor issues, release fallout and/or legal/regulatory/compliance concerns.
Payments Specialist I State Employees Credit UnionPayments Specialist ISanta Fe, NM$20–$23.53 / hourFull timeThis includes ACH posting, wires processing, cash letter, return files processing, ATM deposit adjustments, plastic card process balancing, payroll transfer set up, remote deposit file balancing, and similar processing duties required of the department. Must be capable to execute all terms and conditions set forth in the Employee Handbook, including but not limited to: Works in a safety conscious manner which ensures that safe work practices are used in order not to pose a risk to self or others in the workplace.
NewAuditor/Investigator II Qlarant Quality Solutions IncAuditor/Investigator IINMCollects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs.
Provider Network Management Relations Executive Presbyterian Healthcare ServicesProvider Network Management Relations ExecutiveNMProvides oversight of network strategies and relationship development activities for assigned providers including individualized planning, training and development of providers to align with Presbyterian s clinical quality initiatives. 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.
Scheduling Customer Service Representative-PEH Presbyterian Healthcare ServicesScheduling Customer Service Representative-PEHNMQualifications: High school diploma plus one to three years office/business experience, call center experience preferred and/or claims processing experience preferably in managed care with possible enrollment experience Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, physician office staff. 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.
Contact Representative (Benefits Coordinator) US Department of Health and Human ServicesContact Representative (Benefits Coordinator)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.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistNM$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
Senior Applied & Agentic AI Engineer Sedgwick Claims Management Services, Inc.Senior Applied & Agentic AI EngineerNMNewsweek Recognizes Sedgwick as Americas Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance. Design secure tool integration layers connecting agents to claims systems, policy platforms, data warehouses, document repositories, and external data services.
Nurse Practitioner - (Part-Time) - Santa Fe, NM Commonwealth Medical ServicesNurse Practitioner - (Part-Time) - Santa Fe, NMSanta Fe, 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.
NewBodily Injury Large Loss Adjuster Allstate Insurance CompanyBodily Injury Large Loss AdjusterNM$85,000–$145,075 / yearBodily Injury Claims, Claims Litigation, Client Counseling, Complex Claims, Conflict Management, De-Escalation, Diary Management, Documentations, File Reviews, Industry Trend Analysis, Insurance Claims Investigations, Large Loss Claims, Liability Analysis, Liability Investigations, Litigation, Negotiation, Personal Injury Claims, Prioritization, Torts. Works with Product, Protection, Law, and Claims on new products introduced to the Field and the sales force, and develops Claim Bulletins to provide new forms and/or endorsements that impact claim handling practices.
Customer Service Representative - State Farm Agent Team Member Jamie Dunn - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberSanta Fe, NMAs a Customer Service Representative - State Farm Agent Team Member with Jamie Dunn - 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.
Office Manager Allstate Insurance Agency - Ned JacobsOffice ManagerSanta Fe, NMRight now, we are looking for candidates in the Santa Fe area to lead a team of insurance professionals and help customers protect their homes, cars, lives, and retirement incomes. As an Allstate agency office manager, you’ll be leading the team that keeps customers happy and the business running smoothly.
Optician Sam''''''''s Walmart IncOptician Sam''''''''sSANTA FE, 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.
Freezer, Cooler and Deli Stocker Associate Walmart IncFreezer, Cooler and Deli Stocker AssociateSanta Fe, NM$16–$24.57 / 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.
Customer Service Representative - State Farm Agent Team Member Garrett Seawright - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberSanta Fe, NMAs a Customer Service Representative - State Farm Agent Team Member with Garrett Seawright - 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.
Customer Service Representative - State Farm Agent Team Member Belinda Maez-Ferrero - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberSanta Fe, NMYou will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support. We look forward to connecting with you if you are the customer-focused and empathetic team member we are searching for.
NewRemote HCC Coding Specialist for Risk Adjustment Highmark HealthRemote HCC Coding Specialist for Risk AdjustmentSanta Fe, NMRemoteResponsibilities include working with coding applications, maintaining accuracy, adherence to CMS guidelines, and participating in quality projects. The role delivers critical support in government risk adjusted programs like Medicare Advantage.