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Remote Claims Associate Jobs in Albuquerque, NM (NOW HIRING)

Onco360

Pharmacy Prior Authorization Specialist

Albuquerque, NM · Remote

$19.75 - $25.75/hr

Remote work if licensed in State of New Mexico. Why Join Us? * A career with purpose: Help patients ... Associate degree or Certified Pharmacy Technician (PTCB) * 3+ years of experience in pharmacy or ...

GEICO

Auto Damage Trainee

Albuquerque, NM · On-site +1

$52K/yr

This is not a remote role; you will be required to work in the territory listed on the job posting ... Let GEICO teach you how to write estimates and adjust claims so you can directly assist our ...

All JobsClaims Associate JobsRemote Claims Associate JobsRemote Claims Associate Jobs in Albuquerque, NM

Remote Claims Associate information

See Albuquerque, NM salary details

$13

$20

$29

How much do remote claims associate jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for remote claims associate in Albuquerque, NM is $20.34, according to ZipRecruiter salary data. Most workers in this role earn between $16.54 and $22.36 per hour, depending on experience, location, and employer.

What is a remote claims associate?

A Remote Claims Associate is a professional who reviews, processes, and manages insurance claims from a remote location, typically working from home. They evaluate claim details, verify information, and communicate with policyholders, service providers, and other stakeholders to ensure claims are handled accurately and efficiently. This role often requires strong attention to detail, good communication skills, and proficiency with digital tools and claims management software. Remote Claims Associates may work for insurance companies, third-party administrators, or other organizations handling claims. The position allows for flexibility in work location while maintaining high standards of customer service and accuracy.

What skills and qualifications are needed to be a remote claims associate?

To excel as a Remote Claims Associate, you typically need knowledge of insurance processes, attention to detail, and a high school diploma or relevant experience. Familiarity with claims management software, CRM systems, and sometimes specific certifications like AIC (Associate in Claims) are highly beneficial. Strong organizational skills, effective communication, and the ability to work independently are crucial soft skills for remote success. These competencies ensure accurate claims processing, customer satisfaction, and efficient remote workflow management.

How does a remote claims associate collaborate with other team members while working from home?

As a Remote Claims Associate, you'll regularly communicate with team members, supervisors, and other departments through digital channels like email, instant messaging, and video conferencing. Collaboration often involves sharing updates on claim statuses, seeking guidance on complex cases, and participating in virtual team meetings. Many organizations use workflow management platforms and secure document-sharing tools to ensure seamless coordination and maintain data security. Building strong virtual communication skills is important to stay connected and contribute effectively to team goals.

What are the most commonly searched types of Remote Claims jobs in Albuquerque, NM?

The most popular types of Remote Claims jobs in Albuquerque, NM are:

What are popular job titles related to Remote Claims Associate jobs in Albuquerque, NM?

For Remote Claims Associate jobs in Albuquerque, NM, the most frequently searched job titles are:

What job categories do people searching Remote Claims Associate jobs in Albuquerque, NM look for?

The top searched job categories for Remote Claims Associate jobs in Albuquerque, NM are:

Remote Claims Associate jobs near you
Infographic showing various Remote Claims Associate job openings in Albuquerque, NM as of August 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution, with an average salary of $42,314 per year, or $20.3 per hour.

AVP Claims & Configuration - REMOTE

Prime Therapeutics LLC

Albuquerque, NM • On-site, Remote

$164K - $279K/yr

Full-time

Posted 25 days ago

Prime Therapeutics rating

7.9

Company rating: 7.9 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

16th of 113 rated pharmacies

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
AVP Claims & Configuration - REMOTEJob Description
The Associate Vice President, Claims & Configuration is responsible for the strategic leadership, operational performance, and continuous evolution of pharmacy benefit claims adjudication, benefit configuration capabilities, and network operations. This role ensures accurate, compliant, and scalable administration of pharmacy benefit programs while driving technology modernization, operational efficiency, and client satisfaction.
Responsibilities
  • Lead cross-functional teams responsible for claims adjudication, benefit configuration, testing, and production support
  • Drive modernization and continuous improvement initiatives that enhance operational efficiency, scalability, accuracy, data-driven decision making and customer experience
  • Own execution of the strategy, roadmap, and governance for pharmacy claims adjudication and benefit configuration capabilities, ensuring alignment with business, client, and regulatory requirements
  • Oversee the accurate interpretation and implementation of client benefit plans, formularies, accumulators, pricing, utilization management rules, and clinical programs within claims processing systems
  • Collaborate with key internal partners and business leaders to prioritize enhancements, drive operational transformation to support technology changes, and deliver strategic business outcomes
  • Establish and monitor key performance, quality, compliance, and financial metrics to ensure claims adjudication accuracy, configuration integrity, service excellence, and regulatory compliance
  • Lead operational initiatives to simplify processes, reduce operational risk, improve speed-to-market, and address technical debt across claims and configuration ecosystems
  • Develop organizational capability through talent management, succession planning, budget oversight, and leadership of high-performing teams focused on operational excellence
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in Business, Health Care Administration, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or equivalent GED required
  • 12 years of work experience in PBM, health plan, or healthcare operations, including experience with large scale platform enabled transformations
  • 8 years of leadership/people management experience
  • Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications
  • Demonstrated ability to distill complex concepts or situations into concise and compelling communications
  • Advanced problem-solving skills, including the ability to assess operational, financial, compliance, and client impacts of business decisions
  • Executive presence with exceptional communication, influencing, and stakeholder management skills across operations, technology, clinical, product, and client-facing teams
  • Strong understanding of regulatory and industry requirements impacting pharmacy benefit administration and claims processing
  • Expertise in operational excellence, quality management, risk mitigation, and governance practices within highly regulated environments
  • Ability to lead and develop high-performing teams through coaching, succession planning, organizational design, and talent development

Preferred Qualifications
  • PBM experience, including claims adjudication, benefit configuration, formulary management, pricing, accumulators, and clinical program administration
  • Experience with pharmacy claims adjudication platforms, benefit configuration systems, and implementation of complex client benefit plans

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job
Potential pay for this position ranges from $164,000.00 - $279,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.

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About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

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