• Sr. Provider Reimbursement Professional Certified…

    Humana (Atlanta, GA)
    …Qualifications** + BS in healthcare or business-related field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + CAS claims ... takes to Succeed** + 2 years experience with a coding certification (Industry-recognized coding certification from the...from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement… more
    Humana (11/21/25)
    - Related Jobs

  • Sr. Medical Analyst, RWD

    Norstella (Atlanta, GA)
    …laboratory data, in an academic or industry setting. + Experience working with healthcare coding systems (CPT, NDC, ICD-10) and drug/medication data. + Strong ... Sr. Medical Analyst, RWD Company: MMIT Location: Remote, United...In this role, you will leverage your expertise in ** healthcare data analytics** to extract meaningful insights from **real-world… more
    Norstella (10/28/25)
    - Related Jobs

  • Commercial Billing and Collections Specialist

    PruittHealth (Norcross, GA)
    …and coordination of benefits * Familiarity with medical terminology and the medical record coding process * Knowledge of principles, methods, and techniques ... related to compliant healthcare billing/collections * Familiarity with Insurance Claims ...Demonstrates experience and a proven track record in Insurance Claims in a medical setting of moderate… more
    PruittHealth (11/25/25)
    - Related Jobs

  • PCO Medical Director- UM - Full Time

    CenterWell (Atlanta, GA)
    …help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care ... variable factors. The Medical Director relies on medical background and reviews health claims . The...An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes,… more
    CenterWell (11/06/25)
    - Related Jobs

  • Senior Software Product Engineer (Remote…

    VetsEZ (GA)
    …platforms, we enable smarter decisions, seamless patient engagement, and more efficient claims management. Together, we are shaping a healthcare ecosystem that ... and deploy scalable, AI-enabled microservices using AWS, Node.js, and Python to power healthcare platforms that handle high-volume clinical and claims data. +… more
    VetsEZ (10/02/25)
    - Related Jobs

  • Medical Director - Medicaid N. Central

    Humana (Atlanta, GA)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background,...but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes… more
    Humana (10/25/25)
    - Related Jobs

  • Senior Analyst, Investigations

    CVS Health (Atlanta, GA)
    …skills, with experience in healthcare fraud detection. + Proficiency in interpreting claims data, medical coding , and regulatory frameworks. + Excellent ... and coding practices, verifying document authenticity, and identifying false claims or improper billing. + **Data-Driven Analysis** : Utilizes advanced data… more
    CVS Health (11/26/25)
    - Related Jobs

  • Sr Enterprise Rules and Edits Consultant

    Waystar (Atlanta, GA)
    …industry changes and compliance issues, focusing on government/payer requirements for claims billing & coding /authorization * Leverage analytical tools (Excel, ... planning, implementation, and stabilization. The Consultant will leverage billing and coding subject matter expertise and industry experience to advise clients in… more
    Waystar (09/23/25)
    - Related Jobs

  • Clinical Research Analyst, Senior - Remote

    Prime Therapeutics (Atlanta, GA)
    …lead analyst in producing reports, scorecards, or other data using Pharmacy and/or Medical claims data to support projects and initiatives throughout the ... relevant Healthcare experience including: analyzing and using healthcare claims data, clinical research study design,...study design, and/or epidemiology + Previous experience with SQL coding + Must be eligible to work in the… more
    Prime Therapeutics (11/25/25)
    - Related Jobs

  • Home Infusion Pharmacy Billing Supervisor

    PruittHealth (Norcross, GA)
    …supervisor oversees a team of billing professionals, maintains compliance with healthcare regulations, and drives continuous improvement in revenue cycle processes. ... all home infusion services. * Oversee the preparation and submission of insurance claims , verify patient benefits and payer contracts, and manage follow-up on denied… more
    PruittHealth (11/13/25)
    - Related Jobs