• AR Specialist

    Peachtree Orthopedics (Atlanta, GA)
    …patients. Essential Duties and Responsibilities + Responsible for a variety of medical office /clerical tasks relating to claims processing; contact patients ... edits and other billing messages to resolve any claims denials to ensure prompt resolution . +...education degree (GED) required. + Minimum 5 years of medical billing and account follow up experience preferred. +… more
    Peachtree Orthopedics (10/10/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Augusta, GA)
    …for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with ... Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from… more
    Molina Healthcare (10/16/25)
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  • Billing & Coding Specialist

    Ortho Sport and Spine Physicians (Atlanta, GA)
    …DUTIES: Remain HIPAA and OSHA compliant. Translate patient information and alphanumeric medical code entries. Electronic "clean" claims submissions to Insurance ... are seeking a qualified and dedicated Billing and Coding Specialist to join our Central Billing Office. In this...on accepted or denied claims . Review denied claims for denial reasons and provide resolution .… more
    Ortho Sport and Spine Physicians (10/11/25)
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  • Wellspect Customer Care Specialist

    Dentsply Sirona (Braselton, GA)
    …Administration, Business, or a related field. + Additional certifications in medical billing, insurance claims processing, or healthcare administration are ... : 81461 Wellspect Healthcare is a leading global provider of innovative medical devices that help people suffering from urinary retention or chronic constipation.… more
    Dentsply Sirona (09/23/25)
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  • Senior Specialist , Provider Network…

    Molina Healthcare (GA)
    …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... areas of responsibility (eg, Provider Services/Provider Inquiry Research & Resolution , Provider Contracting/Provider Relationship Management). + Provides timely, accurate… more
    Molina Healthcare (09/17/25)
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  • Associate Specialist , Appeals & Grievances

    Molina Healthcare (Atlanta, GA)
    …for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized) representatives in accordance with the standards ... to state and federal and Molina Healthcare guidelines. + Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research. +… more
    Molina Healthcare (10/16/25)
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  • Registered Nurse - Clinical Appeals & Denials…

    Cognizant (Atlanta, GA)
    …to the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution . You will be a valued ... accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals, and retro-authorization as well as timely filing deadlines and… more
    Cognizant (10/09/25)
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  • Claim Operations Specialist

    Travelers Insurance Company (Alpharetta, GA)
    …Partners with claim professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, ... statements. Prints and prepares claim documents for legal and medical reviews. Reports and assigns claims , and...legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site… more
    Travelers Insurance Company (10/13/25)
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  • Lead Data Scientist - Research and Development…

    Highmark Health (Atlanta, GA)
    …relationships hold the key to uncovering society's most complex challenges? Do you see medical records not just as disparate facts, but as a vast, dynamic network of ... work will directly impact millions of lives. As our Lead Graph Intelligence specialist , you will be the spearhead of cutting-edge research projects. This means… more
    Highmark Health (08/29/25)
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  • Patient Access Representative, PRN

    Trinity Health (Lavonia, GA)
    …& ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information to ... analyzes information. Identifies opportunities, develops solutions, & leads through resolution . Collaborates on performance improvement activities as indicated by… more
    Trinity Health (10/16/25)
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