• Manager, Medical Economics ( Medicaid )…

    Molina Healthcare (Atlanta, GA)
    …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...- 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare… more
    Molina Healthcare (08/27/25)
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  • Manager, Fraud and Waste * Special Investigations…

    Humana (Atlanta, GA)
    …days/week. **Required Qualifications** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with ... continuously improving consumer experiences **Preferred Qualifications** + Proven knowledge in Medicare and Medicaid regulations + Certifications (BA, MBA, JD,… more
    Humana (09/05/25)
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  • Sr. Product Manager - Claims Management

    Waystar (Atlanta, GA)
    …1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid / Medicare payers. We are deeply committed to living out our organizational ... of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare setting or… more
    Waystar (08/08/25)
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  • Field Reimbursement Director (Remote USA)

    Danaher Corporation (Atlanta, GA)
    …and maintain a comprehensive understanding of national, regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers ... and reimbursement . + Support customers with approved resources for denied claims , payer coverage expansion and inadequate reimbursement . + Respond to and… more
    Danaher Corporation (09/06/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Macon, GA)
    …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations… more
    Molina Healthcare (09/07/25)
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  • Reimbursement Coordinator (Patient…

    Cardinal Health (Atlanta, GA)
    …a lot of different hats, without getting overwhelmed), required * Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers' policies and guidelines ... a background in healthcare (such as medical assistant, working in medical claims /billing, pharmacy technician, clinician in a doctor's office, etc) or with insurance… more
    Cardinal Health (09/03/25)
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  • Senior Analyst, Medical Economics (Vbc) - Remote

    Molina Healthcare (GA)
    …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare… more
    Molina Healthcare (08/31/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Atlanta, GA)
    …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
    Cardinal Health (08/24/25)
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  • Compliance Audit Manager

    Cardinal Health (Atlanta, GA)
    …and/or hospital facility fee coding and auditing. + Expert-level knowledge of Medicare and Medicaid documentation and coding rules and guidelines; ... patient medical records. + Availability to assist with research of denied claims . + Maintains a functional knowledge of enterprise EMRs, the registration process… more
    Cardinal Health (08/27/25)
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  • Healthcare Process Risk Manager (Internal Audit)

    Grant Thornton (Atlanta, GA)
    …related to revenue cycle optimization, including patient access, revenue integrity, coding, claims processing, billing, and reimbursement , with a focus on ... as the Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS). + Experience with Sarbanes-Oxley Section 404 compliance. +… more
    Grant Thornton (09/07/25)
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