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Claims processor Jobs in Albuquerque, NM

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Claims processor • albuquerque nm

Last updated: 2 days ago

Program Manager (Claims - MST hours)

Molina HealthcareAlbuquerque, NM, United States
Full-time

Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vend... Show more

Senior Workers Compensation Claims Adjuster

Arthur J Gallagher & CoAlbuquerque, NM, United States
Full-time

At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose.Every day, we help clients navigate complexity,... Show more

Mortgage Origination - Customer Service Representative Jobs

Clearance JobsAlbuquerque, NM, United States
$20.00 hourly
Full-time

Mortgage Origination Customer Service Representative.Leidos is seeking full-time Mortgage Origination Professionals at the FHA Resource Center in Albuquerque, New Mexico.Our Leidos Customer Service... Show more

INDIRECT LOAN PROCESSOR

Sandia Area Federal Credit UnionAlbuquerque, NM, United States
Full-time

Position Type: Full Time Job Shift: Day Education Level: High School Degree or Equivalent Category: Banking.Schedule of Work: (not a remote or hybrid position).Monday to Friday: 8:30 AM to 5:30 PM.... Show more

Personnel Security Processor

Akima, LLCAlbuquerque, NM, United States
Full-time

Akima Global Technology (AGT), an Akima company, is looking to hire a Personnel Security Processor to support their DoE client in Albuquerque, NM.To join our team of outstanding professionals, appl... Show more

Travel Sterile Processor (1016718)

Titan Medical Group, LLCAlbuquerque, NM, United States
Full-time

Titan Medical is looking for travelers to fill a Travel Sterile Processor position for a 13-week assignment in Albuquerque, NM!. Show more

Assistant Claims Risk Manager

Catholic Mutual GroupAlbuquerque, NM
Full-time

Catholic Mutual Group (CMG) is the leading provider of property, liability, and employee benefit coverage and related services for the Catholic Church across the United States and Canada.We are cur... Show more

Pathways Recent Graduate Claims and Program Representative

US Government JobsAlbuquerque, NM, United States
Full-time

This position is located in the Railroad Retirement Board's Field Service.The incumbent will be responsible for providing a full-range of client services regarding benefits available under the vari... Show more

Remote Insurance Experts - AI Trainer ($50-$60 per hour)

MercorAlbuquerque, New Mexico, US
Remote
Full-time

Role Overview** - Mercor is seeking senior insurance professionals to build evaluation tasks for AI systems operating in Fortune 500 enterprise insurance and risk contexts.The workflows are calibra... Show more

Entry Level Medical Billing Assistant

Revel StaffingAlbuquerque, New Mexico, United States
Full-time
Quick Apply

The Medical Billing Assistant will help prepare and review insurance claims, assist with basic billing and coding tasks, update patient and insurance information, and support the administrative wor... Show more

Financial Coordinator

Haltom OrthodonticsAlbuquerque, New Mexico, United States
$23.00 hourly
Full-time

Verify orthodontic and dental insurance eligibility and benefits and maintain accurate insurance information.Review treatment plans and accurately calculate patient financial responsibility, includ... Show more

Bilingual Mortgage Origination Customer Service Representative

NavstarAlbuquerque, NM, United States
Full-time

Mortgage Origination Customer Service Representative.Leidos is seeking full-time Bilingual Mortgage Origination Professionals at the FHA Resource Center in Albuquerque, NM.Our Leidos Customer Servi... Show more

Sterile Processor

Fusion Medical StaffingAlbuquerque, NM, United States
Full-time

Albuquerque, NM $969-1031 /week* 40 hrs /week.Charting system: Change Healthcare, Datavant, Epic (Cadence, Care Everywhere, ClinDoc), GE Healthcare (Centricity), IBM.Fusion Medical Staffing is seek... Show more

Disability Case Manager

LifeWorks by TelusAlbuquerque, NM, United States
Full-time

TELUS Health is empowering every person to live their healthiest life.Guided by our vision, we are leveraging the power of our leading edge technology and focusing on the uniqueness of each individ... Show more

Account Manager II - Commercial Lines

5H4 Hub Southwest, a Division of Hub International Insurance Services Inc.Albuquerque, NM
Full-time

TheAccount Manager IIwill provide professional, courteous service to our clients, producers, and company personnel.With a positive attitude, theAMwill provide a high level of support in obtaining, ... Show more

Back room processor

HomeGoodsAlbuquerque, New Mexico, 87114
Part-time

At TJX Companies, every day brings new opportunities for growth, exploration, and achievement.You’ll be part of our vibrant team that embraces diversity, fosters collaboration, and prioritizes your... Show more

Commercial Claims Adjuster - Carrier or TPA - REMOTE

Work At Home Vintage ExpertsAlbuquerque, NM, US
Remote
Full-time +2
Quick Apply

Put your Insurance Experience to work – FROM HOME!.Our unique platform provides you with.WHAT YOU’LL LOVE ABOUT WAHVE.We created a welcoming place to work with friendly and professional... Show more

Workers Compensation Claims Supervisor - NM

GallagherAlbuquerque, New Mexico
Full-time

Role specifics: Claims Background: Workers Compensation Prior leadership experience: 1-2+ years of supervisory experience Jurisdictional experience: NM Licenses: NM Location: This role is eligible ... Show more

Pathways Recent Graduate Claims and Program Representative

US Government Jobs - Other AgenciesAlbuquerque, NM, United States
$52,059.00 yearly
Permanent

Pathways Recent Graduate Claims And Program Representative.The RRB Recent Graduates Program affords developmental experiences in the Federal Government intended to promote possible careers in the c... Show more

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Program Manager (Claims - MST hours)

Program Manager (Claims - MST hours)

Molina HealthcareAlbuquerque, NM, United States
30+ days ago
Job type
  • Full-time
Job description

Job Description

Job Summary

Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable.

Job Duties

  • Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective claims & claims configuration program.
  • Manages program budget, as applicable, supporting project prioritization.
  • Collaborates with Legal, Compliance, and Information Security to ensure governance standards are upheld.
  • Tracks performance metrics and ensures value realization from deployed solutions.
  • Coordinates recurring meetings to support governance framework and decision-making processes, as needed.
  • At the direction of program (CoE, Shared Service or other functional area) leadership, supports portfolio management and/or initiative-specific change and project management.
  • Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices and other collateral.
  • Routinely reviews program collateral to ensure current and accurate reflection of business needs.
  • Identifies opportunities/gaps and provides recommendations on program enhancements to respective leadership team.
  • Responsible for creating business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
  • Generates and distributes standard reports on schedule.

Job Qualifications

Required Qualifications:

  • At least 4 years of Program and/or Project management experience, or equivalent combination of relevant education and experience.
  • Operational Process Improvement experience.
  • Managed Care experience, preferably in a shared service, CoE or matrixed environment.
  • Experience with Microsoft Project and Visio.
  • Strong presentation and communication skills.

Preferred Qualifications:

  • Claims & claims configuration experience.
  • QNXT
  • Provider Relations

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.