• Associate Specialist, Appeals & Grievances

    Molina Healthcare (Augusta, GA)
    JOB DESCRIPTION Job Summary Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating ... information system and prepares documentation for further review. * Researches claims issues utilizing systems and other available resources. * Assures timeliness… more
    Molina Healthcare (11/21/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Savannah, GA)
    …likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical knowledge, knowledge ... specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific program… more
    Molina Healthcare (11/14/25)
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  • Senior Healthcare Economics Analyst - Cost…

    Elevance Health (Atlanta, GA)
    **Senior Healthcare Economics Analyst** **Location:** Chicago, IL; Atlanta, GA; Indianapolis, IN; Richmond, VA (preferred). This role requires associates to be ... not eligible for current or future visa sponsorship._ The **Senior Healthcare Economics Analyst** (Advanced Analytics Analyst Senior) creates statistical models to… more
    Elevance Health (10/29/25)
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  • Biller 1

    Aveanna Healthcare (Atlanta, GA)
    …any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions ... correct and update EMR. Works with Collector to ensure claims are refiled and/or billed to the second insurance...school diploma or equivalent. Minimum six (6) month prior healthcare insurance experience. Computer literate and ability to type,… more
    Aveanna Healthcare (10/28/25)
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  • Provider Relations Consultant - Transplant

    Emory Healthcare/Emory University (Atlanta, GA)
    **Overview** **Be inspired** **.** **Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel your professional journey with better benefits, ... to enhance referral integration and provider relations across the healthcare system. **Primary duties and responsibilities:** **Referral and Development Strategy:**… more
    Emory Healthcare/Emory University (11/11/25)
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  • Financial Counselor - EHI

    Emory Healthcare/Emory University (Duluth, GA)
    **Overview** **Be inspired** **.** **Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel your professional journey with better benefits, ... ? accounts to improve revenue and timely processing of claims . + Responsible for financially clearing patients prior to,...have knowledge and ability to perform aspects of Emory Healthcare processes from registration to billing. + This position… more
    Emory Healthcare/Emory University (10/01/25)
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  • Principal Consultant

    Oracle (Atlanta, GA)
    …data in at least one visualization tool like BO or Tableau + Healthcare experience with Medicaid/Medicare Claims Reporting **Expectations** + Perform other ... and save lives. Our mission? To create a human-centric healthcare experience powered by unified global data. It's a...care across the globe. If you're excited about making healthcare more human, you've come to the right place.… more
    Oracle (11/25/25)
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  • Director, Consult Partner - Contact Center…

    Kyndryl (Atlanta, GA)
    …transforming Contact Center operations for enterprise organizations, particularly those in the Healthcare or State or Local Government and / or Educational (SLED) ... communication, presentation, and stakeholder management skills with C-Level. + Healthcare industry experience is a strong plus, especially in payer/provider… more
    Kyndryl (10/30/25)
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  • Healthcare Process Risk Manager

    Grant Thornton (Atlanta, GA)
    …4 years of direct experience with diverse life sciences companies or healthcare providers, including hospitals, academic medical centers, healthcare systems, and ... to revenue cycle optimization, including patient access, revenue integrity, coding, claims processing, billing, and reimbursement, with a focus on enhancing… more
    Grant Thornton (10/14/25)
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  • AVP, Provider Contract Network Management…

    The Cigna Group (Atlanta, GA)
    …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... + Should possess a bachelor degree; preferably in the areas of Finance, Economics, Healthcare or Business related. MBA or MHA preferred. + **5+ years Contracting and… more
    The Cigna Group (09/20/25)
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