- Magellan Health Services (Albuquerque, NM)
- …which would provide an equivalent background may be considered. General Job Information Title Claims Resolution Analyst Grade 21 Work Experience - Required ... The Claims Internal Resolution Analyst is responsible for coordinating the resolution of claims issues locally at the health plan by actively… more
- Molina Healthcare (Albuquerque, NM)
- **Job Description** **Job Summary** Provides entry level analyst support for claims research activities. This role plays a pivotal role in ensuring the timely ... and accurate resolution of provider-submitted claims issues. This role requires a keen understanding of medical claims processing, strong analytical skills,… more
- Molina Healthcare (Albuquerque, NM)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (Albuquerque, NM)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, accurate, ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
- Molina Healthcare (Albuquerque, NM)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... claim payment system and other applicable systems. + Participates in defect resolution for assigned component + Assists with development of configuration standards… more
- Molina Healthcare (Albuquerque, NM)
- …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... ensuring the highest quality on every project/request. Responsible for error resolution , follow up and performance metrics monitoring. + Provides peer review… more