• Licensed Practical Nurse/Licensed Vocational Nurse…

    STG International (Milledgeville, GA)
    …of absence and bed-holds per facility policies; document census as established for billing and clinical purposes. + Assist with safe and orderly resident transfers ... Coordinate Pre-certification sand recertification in accordance with facility policies for Medicare Advantage and + commercial insurance payers. + Interpret the… more
    STG International (10/23/25)
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  • Clinical Registered Nurse - Utilization Management…

    Cognizant (Atlanta, GA)
    …clinical denials including but not limited to referral, preauthorization, medical necessity, non-covered services, investigational/experimental and billing ... the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member… more
    Cognizant (11/25/25)
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  • Registered Nurse Consultant (Nationwide)

    Vatica Health (Atlanta, GA)
    …the ability to effectively communicate with physicians, advanced practice providers and medical office personnel such as Practice and Billing Manager, both ... patient data to improve care coordination, quality metrics, and medical cost savings. The ideal candidate has a track...care (ie, ICU/CCU/MICU) and/or ED) + Proficiency with Diagnosis, Billing , and Quality Measures Coding a plus + Excellent… more
    Vatica Health (09/08/25)
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  • Associate Specialist, Appeals & Grievances

    Molina Healthcare (Augusta, GA)
    …* Customer/provider experience in a managed care organization (Medicaid, Medicare , Marketplace and/or other government-sponsored program), or medical ... the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** *...a health care related vocational program (ie, certified coder, billing , or medical assistant). To all current… more
    Molina Healthcare (11/21/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Marietta, GA)
    billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers to ... + Homecare Homebase (HCHB) experience is highly preferred. + CMS PDGM billing knowledge and/or experience, preferred. **Additional Information** + Normal Hours of… more
    CenterWell (10/24/25)
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  • Sr Enterprise Rules and Edits Consultant

    Waystar (Atlanta, GA)
    …scoping, project planning, implementation, and stabilization. The Consultant will leverage billing and coding subject matter expertise and industry experience to ... changes and compliance issues, focusing on government/payer requirements for claims billing & coding/authorization * Leverage analytical tools (Excel, PowerBI, SQL… more
    Waystar (09/23/25)
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  • Senior Business Intelligence Engineer

    Humana (Atlanta, GA)
    …Intelligence Engineer position will be supporting BI work for our Medicare organizations. **Senior Business Intelligence Engineer** : + Develops and maintains ... complex data sets within large organizations + Experience working with Claims, Billing and Reconciliation or related healthcare data + Expertise in Microsoft Office… more
    Humana (11/27/25)
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  • Patient Account Assoc I Credit Balances

    Intermountain Health (Atlanta, GA)
    Billing , Follow-Up, Collections) required + Knowledge of Medicaid and Medicare billing regulations required **Physical Requirements** + Operate computers and ... + Understanding Coordination of Benefits + Understanding EOB + Understanding Medical Terminology + Payment Handling + Effective written and verbal communication… more
    Intermountain Health (11/27/25)
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  • Nurse Practitioner Palliative Care

    Gentiva (Madison, GA)
    …diagnosis, treatment, consultation, and follow-up under the direction of the Palliative Medical Director (if required under State law). **As a Nurse Practitioner, ... you will:** + Work in collaboration with the Palliative Care Medical Director and other palliative team members to deliver palliative care by providing diagnosis,… more
    Gentiva (11/19/25)
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  • Patient Access Representative

    Trinity Health (Lavonia, GA)
    …Qualifications:** + Knowledge of insurance and governmental programs, regulations and billing processes ( Medicare , Medicaid, Social Security Disability, Tricare, ... being friendly, professional and respectful, to guarantee the flow of accurate medical , insurance and demographic information throughout the system. **What you will… more
    Trinity Health (11/14/25)
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