• Appeals Nurse

    Humana (Atlanta, GA)
    …where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may be needed ... + Maintain knowledge of TRICARE, all HGB policies and procedures as well as medical necessity review criteria and privacy requirements **Use your skills to make an… more
    Humana (12/11/25)
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  • Clinical Pharmacist Principle

    Humana (Atlanta, GA)
    …Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing , prior authorization, formulary management and clinical ... first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes… more
    Humana (12/10/25)
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  • Healthcare Process Risk Manager

    Grant Thornton (Atlanta, GA)
    …related to revenue cycle optimization, including patient access, revenue integrity, coding, claims processing , billing, and reimbursement, with a focus on ... Thornton interns are eligible to participate in the firm's medical , dental and vision insurance programs and the firm's employee assistance program. Interns also… more
    Grant Thornton (10/14/25)
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  • Grievances and Appeals Representative

    Humana (Atlanta, GA)
    …2 - 4 years of grievance and/or appeals experience. + Previous experience processing medical claims . **Additional Information** + **Workstyle:** remote, work ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
    Humana (12/11/25)
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  • Sales Trainee

    Consolidated Electrical Distributors (Dalton, GA)
    …Training 6 weeks + Safety and equipment operation; shipping/receiving; freight claims ; paper processing ; backorders; warehouse organization; product familiarity ... + Profit Sharing Benefits: Benefits available for this position are: + Insurance - Medical , Dental, Vision Care for full-time positions + Disability Insurance more
    Consolidated Electrical Distributors (10/21/25)
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  • Managing Director, Actuarial Services

    Evolent (Atlanta, GA)
    …and contracting. **What You'll Be Doing:** + Serve as the lead for medical cost and revenue projections for Performance Suite business + Partner with Performance ... and size impact of innovative care models + Oversee Medical Cost Action Planning work to identify, size, and...clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for… more
    Evolent (10/21/25)
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  • Pharmacy Operations Manager

    Walgreens (Watkinsville, GA)
    …to pharmacy errors and the Continuous Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and ... prevent payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. + Assists and… more
    Walgreens (12/11/25)
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  • Sr. Customer Service Representative

    Robert Half Office Team (Macon, GA)
    …effectively using strong analytical and problem-solving skills. * Process and track insurance claims , payments, and follow-ups while maintaining detailed logs. ... in the United States. Benefits are available to contract/temporary professionals, including medical , vision, dental, and life and disability insurance . Hired… more
    Robert Half Office Team (12/05/25)
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  • Senior Data Engineer

    CVS Health (Atlanta, GA)
    …The position is open in a data engineering team that is responsible for processing Claims , Revenue, Rx Medicare Specific files and data from 30+ payors ... written communication skills + Familiarity with healthcare data and healthcare insurance feeds **Education** + Bachelor's degree in Computer Science / Engineering… more
    CVS Health (12/13/25)
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  • WMS Analyst

    Lowe's (Palmetto, GA)
    …off for vacations, holidays and sick time, as well as access to top-tier medical , dental and vision insurance . For information about our benefit programs and ... Flatbed Fulfillment Center (FFC). Your day involves reviewing calls, emails, and claims , providing status updates, processing special orders, and monitoring load… more
    Lowe's (12/11/25)
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