ZipRecruiter

Log In

2

Remote Claims Jobs in Rio Rancho, NM (NOW HIRING)

micro1 AI

AI Training Specialist - Physics

Albuquerque, NM · On-site +1

$80 - $150/hr

Remote (US, Canada, UK focused) micro1 is engaging Physics Experts (Postdoc / Junior professor) to ... scientific claims as appropriate. * Deliver structured feedback designed to support iterative ...

micro1 AI

Regulatory Affairs Specialist

Rio Rancho, NM · Remote

$50 - $70/hr

Remote micro1 is engaging Regulatory Affairs Specialists to contribute to a customer's project ... conflicting claims within or between documents. * Provide structured, well-reasoned written ...

micro1 AI

AI Training Specialist - Physics

Rio Rancho, NM · On-site +1

$80 - $150/hr

Remote (US, Canada, UK focused) micro1 is engaging Physics Experts (Postdoc / Junior professor) to ... scientific claims as appropriate. * Deliver structured feedback designed to support iterative ...

micro1 AI

Compliance Officers

Rio Rancho, NM · Remote

$50 - $70/hr

Remote micro1 is engaging Regulatory Affairs Specialists to contribute to a customer's project ... conflicting claims within or between documents. * Provide structured, well-reasoned written ...

micro1 AI

Compliance Officers

Albuquerque, NM · Remote

$50 - $70/hr

Remote micro1 is engaging Regulatory Affairs Specialists to contribute to a customer's project ... conflicting claims within or between documents. * Provide structured, well-reasoned written ...

micro1 AI

Regulatory Affairs Specialist

Albuquerque, NM · Remote

$50 - $70/hr

Remote micro1 is engaging Regulatory Affairs Specialists to contribute to a customer's project ... conflicting claims within or between documents. * Provide structured, well-reasoned written ...

previous pagenext page

Showing results 21-40

All JobsClaims JobsRemote Claims JobsRemote Claims Jobs in Rio Rancho, NM

Remote Claims information

See Rio Rancho, NM salary details

$27.5K

$58.3K

$81.2K

How much do remote claims jobs pay per year?

As of Aug 14, 2026, the average yearly pay for remote claims in Rio Rancho, NM is $58,271.00, according to ZipRecruiter salary data. Most workers in this role earn between $46,000.00 and $68,100.00 per year, depending on experience, location, and employer.

What are common challenges faced by remote claims professionals, and how can they be managed?

Remote claims professionals often encounter challenges such as maintaining effective communication with team members and clients, managing time independently, and ensuring data security while handling sensitive information from home. To address these, it’s important to utilize collaboration tools, set structured work hours, and follow strict company protocols for cybersecurity. Regular virtual meetings and clear documentation can help maintain workflow efficiency and keep everyone aligned.

What skills and qualifications are needed to thrive as a remote claims specialist?

To thrive as a Remote Claims Specialist, you need a solid background in insurance processes, claims assessment, and a relevant educational qualification such as a degree in business or insurance. Familiarity with claims management software, CRM systems, and sometimes industry certifications like AIC (Associate in Claims) are commonly required. Strong attention to detail, effective communication, and self-motivation are crucial soft skills for managing cases independently and supporting clients remotely. These abilities ensure accurate, timely processing of claims and high levels of customer satisfaction in a virtual work environment.

What is a remote claims job?

Remote claims jobs involve evaluating, processing, and managing insurance claims from a remote location, typically from home. Professionals in these roles review claims submitted by clients, investigate the details, and determine the coverage or payment amounts according to company policies and regulations. These positions require strong analytical, communication, and organizational skills, along with a good understanding of insurance processes. Many insurance companies now offer remote claims roles, providing flexibility and work-from-home opportunities.

What is the difference between Remote Claims vs Remote Claims Adjuster?

AspectRemote ClaimsRemote Claims Adjuster
Required CredentialsVaries by role, often includes insurance knowledgeLicenses often required, such as state-specific adjuster licenses
Work EnvironmentRemote, office, or hybridPrimarily remote, with some fieldwork possible
Industry UsageInsurance companies, third-party administratorsInsurance companies, claims management firms
Common Search IntentGeneral claims roles, customer service, claims processingClaims evaluation, damage assessment, settlement

Remote Claims roles encompass a broad range of insurance-related positions, including claims processing and customer service, often without requiring specific licenses. Remote Claims Adjusters focus on evaluating claims, assessing damages, and may need state licenses. Both roles are remote-friendly and serve the insurance industry, but adjusters typically have more specialized credentials and responsibilities.

What are the most commonly searched types of Claims jobs in Rio Rancho, NM?

The most popular types of Claims jobs in Rio Rancho, NM are:

What are popular job titles related to Remote Claims jobs in Rio Rancho, NM?

For Remote Claims jobs in Rio Rancho, NM, the most frequently searched job titles are:

What job categories do people searching Remote Claims jobs in Rio Rancho, NM look for?

The top searched job categories for Remote Claims jobs in Rio Rancho, NM are:

What cities near Rio Rancho, NM are hiring for Remote Claims jobs?

Cities near Rio Rancho, NM with the most Remote Claims job openings:

Remote Claims jobs near you
Infographic showing various Remote Claims job openings in Rio Rancho, NM as of August 2026, with employment types broken down into 1% Internship, 86% Full Time, 10% Part Time, and 3% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $58,271 per year, or $28 per hour.

Regulatory Analyst Sr (Remote)

Prime Therapeutics LLC

Albuquerque, NM • On-site, Remote

$81K - $138K/yr

Full-time

Posted 12 days ago

Prime Therapeutics rating

7.9

Company rating: 7.9 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

17th of 112 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
Regulatory Analyst Sr (Remote)Job Description
The Senior Regulatory Analyst is responsible for leading portions of departmental regulatory review and analysis, external audits and accreditation processes, and participates in committee review meetings within the Commercial, Medicare, Medicaid, and Health Insurance Marketplace for the assigned department. This position is responsible for being the primary point of contact for new internal and external business partners with regard to related regulatory activity and quality efforts involving utilization and/or medication therapy management, network management, client delegation agreements and accreditation entities, SOP development and maintenance, and development and maintenance of audit protocols.
Responsibilities
  • Participate in Regulatory Review Committee Meetings, Healthcare Reform Meetings, Regulatory Oversight Meetings, CMS User Calls, and Government Programs Compliance Committee Meetings to monitor new regulations and provide necessary updates to these committees
  • Monitor national and state healthcare regulation requirements and update appropriate stakeholders of changes or new requirements
  • Take the lead on any new business issues and opportunities generated by Government and/or Commercial laws, rules, regulations or guidelines that impact Consumer Delivery
  • Ensure successful implementation and execution of regulatory compliance requirements including project leadership and governance; ensure appropriate requirements are in place for new Client and Group implementations
  • Establish and maintain engaged relationships with leadership of other functional areas within the corporation (can include Government Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations, Paper Claims, Member Materials, IT, etc.) to ensure effective collaboration, communication, and delivery of required regulations
  • Recommend changes to policies and procedures based on regulatory changes
  • Liaison with Internal Audit and External Audit teams to represent departments in CMS, Client, mock, and vendor audits
  • Review audit feedback, initiate action items related to audit or compliance review findings, and recommend ideas for improvement and summarize action plans
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in business, finance, health services or related area of study, or equivalent combination of education and/or relevant work experience
  • 5 years of successful project management and/or operations management experience related to, or within Pharmacy Benefit Management (PBM) or health insurance
  • 2 years Medicare Part D, Medicaid, and/or federal regulatory experience
  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
  • Excellent verbal and written communication skills including interpersonal skills necessary to drive results and deliver on commitments
  • Proficient at meeting facilitation, conflict management, and consensus building
  • Proven client service skills with a track record for building strong client relations
  • Ability to handle multiple projects simultaneously and to work under pressure with strict timelines
  • Proven problem solving and solution crafting skills
  • Demonstrated critical thinking and analysis skills with the ability to interpret regulations into operational requirements

Preferred Qualifications
  • Prior experience giving presentations
  • Proficient in Microsoft Project and Visio
  • Extensive knowledge of CMS regulations and Health Care
  • Commercial Clinical review experience

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 $81,000.00 - $138,000.00 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.

What Prime Therapeutics employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Prime Therapeutics logo

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

Social media

FacebookTwitter

View All Prime Therapeutics Jobs

Apply