Patient Service Specialist Visa Sponsorship Jobs in New Mexico
Patient service specialist roles in New Mexico are concentrated in Albuquerque, where large health systems like Presbyterian Healthcare Services and UNM Health anchor the market, along with facilities in Santa Fe and Las Cruces. International candidates with healthcare administration backgrounds will find sponsorship activity tied mainly to hospital networks and federally qualified health centers serving the state's diverse population.
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Get Access To All JobsLocation Address:
9521 San Mateo NE Albuquerque, NM 87113-2237
Compensation Pay Range:
Minimum Offer $18.33 Maximum Offer $27.25
Now Hiring: Clinical Pharmacy Review Specialist
Summary
Build your Career. Make a Difference. Presbyterian is hiring a skilled Clinical Pharmacy Review Specialist to join our team.
Type of Opportunity: Full time
Job Exempt: No
Job is based: Reverend Hugh Cooper Administrative Center
Work Shift: Days (United States of America)
Responsibilities:
The Clinical Pharmacy Review Specialist works under the direct supervision of a Clinical Pharmacist within the Pharmacy Services Department.
This position is responsible for providing clinical support for the Fluent Health Pharmacy Services Department surrounding clinical case review submissions. This includes preparing and researching clinical data for coverage determinations, prior authorizations, direct member reimbursement, point of sale determinations, and appeals and grievances.
Some key responsibilities include:
- Preforms first level review and evaluation of prior authorization requests for appropriateness, deviation from established medical standards policies, medical contraindications, coverage criteria or protocols
- Completes documentation review and requests additional information from prescribing physicians to establish medical necessity and forwards to clinical pharmacists for second level review.
- Ability to apply critical thinking skills and use reference documents, clinical criteria, policies and procedures and desktop procedures to complete tasks
- Assign, enter and interpret submitted documentation regarding prior authorization requests into appropriate claims processing system.
- Ability to communicate information to members, providers, pharmacists and pharmacy staff on issues related to benefit coverage, formulary, non-formulary criteria, or respective policies and procedures.
- Knowledge of drug nomenclature, basic pharmacology, dosage calculations, units of measure, prescription filling techniques, prescription documentation requirements, pharmacy laws and regulations, basic managed care pharmacy principles and insurance coverage issues.
- Knowledge of Pharmaceutical products, including oral, injectable, infusion products and chemotherapy drugs.
- Respond to member inquiries on the phone or on line requests for pharmacy coverage inquiries
- Effective oral and written communication skills.
- Ability to analyze rejected pharmacy claims and identify resolution for successful claims submission and processing.
- May perform activities that require evaluation or interpretation of information related to drug administration and treatments.
- Assist Clinical Pharmacist in review of Members medication regimen and assist in Medication Therapy Management
- Ability to meet established deadlines timely, accurately and with a sense of urgency
- Responsible for knowing and interpreting pharmacy and medical benefits.
- Knowledge of Medical terminology and HIPAA regulations
- Perform other duties as assigned.
Qualifications
- GED or High School diploma is required.
- Certified Pharmacy Technician-PTCB is required
- Experience with pharmacy benefits management, health insurance and or prescription benefits is preferred
- Retail Pharmacy experience preferred
- Managed care customer service experience preferred
- Drug Information skills
- Experience with Medicare Part D insurance and Medicaid programs
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.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinars, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services
Location Address:
9521 San Mateo NE Albuquerque, NM 87113-2237
Compensation Pay Range:
Minimum Offer $18.33 Maximum Offer $27.25
Now Hiring: Clinical Pharmacy Review Specialist
Summary
Build your Career. Make a Difference. Presbyterian is hiring a skilled Clinical Pharmacy Review Specialist to join our team.
Type of Opportunity: Full time
Job Exempt: No
Job is based: Reverend Hugh Cooper Administrative Center
Work Shift: Days (United States of America)
Responsibilities:
The Clinical Pharmacy Review Specialist works under the direct supervision of a Clinical Pharmacist within the Pharmacy Services Department.
This position is responsible for providing clinical support for the Fluent Health Pharmacy Services Department surrounding clinical case review submissions. This includes preparing and researching clinical data for coverage determinations, prior authorizations, direct member reimbursement, point of sale determinations, and appeals and grievances.
Some key responsibilities include:
- Preforms first level review and evaluation of prior authorization requests for appropriateness, deviation from established medical standards policies, medical contraindications, coverage criteria or protocols
- Completes documentation review and requests additional information from prescribing physicians to establish medical necessity and forwards to clinical pharmacists for second level review.
- Ability to apply critical thinking skills and use reference documents, clinical criteria, policies and procedures and desktop procedures to complete tasks
- Assign, enter and interpret submitted documentation regarding prior authorization requests into appropriate claims processing system.
- Ability to communicate information to members, providers, pharmacists and pharmacy staff on issues related to benefit coverage, formulary, non-formulary criteria, or respective policies and procedures.
- Knowledge of drug nomenclature, basic pharmacology, dosage calculations, units of measure, prescription filling techniques, prescription documentation requirements, pharmacy laws and regulations, basic managed care pharmacy principles and insurance coverage issues.
- Knowledge of Pharmaceutical products, including oral, injectable, infusion products and chemotherapy drugs.
- Respond to member inquiries on the phone or on line requests for pharmacy coverage inquiries
- Effective oral and written communication skills.
- Ability to analyze rejected pharmacy claims and identify resolution for successful claims submission and processing.
- May perform activities that require evaluation or interpretation of information related to drug administration and treatments.
- Assist Clinical Pharmacist in review of Members medication regimen and assist in Medication Therapy Management
- Ability to meet established deadlines timely, accurately and with a sense of urgency
- Responsible for knowing and interpreting pharmacy and medical benefits.
- Knowledge of Medical terminology and HIPAA regulations
- Perform other duties as assigned.
Qualifications
- GED or High School diploma is required.
- Certified Pharmacy Technician-PTCB is required
- Experience with pharmacy benefits management, health insurance and or prescription benefits is preferred
- Retail Pharmacy experience preferred
- Managed care customer service experience preferred
- Drug Information skills
- Experience with Medicare Part D insurance and Medicaid programs
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.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinars, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services
Patient Service Specialist Job Roles in New Mexico
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Search Patient Service Specialist Jobs in New MexicoPatient Service Specialist Jobs in New Mexico: Frequently Asked Questions
Which companies sponsor visas for patient service specialists in New Mexico?
Presbyterian Healthcare Services, UNM Health (University of New Mexico Health Sciences), Lovelace Health System, and Christus St. Vincent Regional Medical Center in Santa Fe are among the larger employers in New Mexico with established HR infrastructure for visa sponsorship. Federally qualified health centers serving rural and tribal communities also periodically sponsor international workers, though sponsorship is never guaranteed and depends on the role, staffing needs, and employer resources at the time of hiring.
Which visa types are most common for patient service specialist roles in New Mexico?
The H-1B visa is the most widely used visa for patient service specialists, provided the role requires at least a bachelor's degree in a specific field such as healthcare administration or health information management. TN visa status is available to Canadian and Mexican nationals under USCIS-recognized specialty occupations. Some employers also support permanent residence through EB-3 for qualified administrative healthcare workers. The appropriate category depends on the specific duties of the role and the employer's willingness to sponsor.
How to find patient service specialist visa sponsorship jobs in New Mexico?
Migrate Mate is built specifically to surface visa sponsorship jobs for international candidates, including patient service specialist roles in New Mexico. You can filter by state and role to see active listings from employers who have indicated sponsorship willingness. Because New Mexico's healthcare market is concentrated in Albuquerque with secondary hubs in Santa Fe and Las Cruces, narrowing your search geographically on Migrate Mate helps identify which local health systems and clinics are actively hiring internationally.
Which cities in New Mexico have the most patient service specialist sponsorship jobs?
Albuquerque accounts for the large majority of patient service specialist openings in New Mexico, driven by UNM Health, Presbyterian Healthcare Services, and Lovelace Health System. Santa Fe has a smaller but consistent presence through Christus St. Vincent and state government health facilities. Las Cruces is the next significant market, anchored by Memorial Medical Center and proximity to El Paso's broader healthcare corridor. Rural areas occasionally post roles but sponsorship activity there is less common.
Are there state-specific considerations for patient service specialists seeking sponsorship in New Mexico?
New Mexico's significant Native American and Hispanic populations have driven state investment in community health programs and federally qualified health centers, which can expand sponsorship opportunities for candidates with bilingual skills or experience in culturally competent care. The University of New Mexico produces a pipeline of locally trained healthcare workers, so international candidates should be prepared to demonstrate qualifications that complement rather than duplicate that local supply. Prevailing wage requirements under H-1B rules apply statewide and are determined by the specific metropolitan area and job classification.
What is the prevailing wage for sponsored patient service specialist jobs in New Mexico?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.