27 adjudication jobs at 13 companies in Georgia
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Claims Consultant
Brunswick, Georgia, United States
$48k-$55k/yr OnsiteFull Time
4+ YOEExperience adjudicating disability/FMLA/PFL claims, medical record review, FINEOS proficiency, strong analytical and communication skills, MS Office proficiency.
FINEOS, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
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Claims Supervisor
Corvallis or Alabama or Alaska or Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Pennsylvania or Rhode Island or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
4+ YOE2+ MgmtHigh school diploma, 4 years claims experience (adjudication/benefits/COB), 2 years leadership, strong communication and problem-solving skills.
2w
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Senior Account Manager, Remote
Atlanta, Georgia, United States
$125k-$140k/yr RemoteFull Time
8+ YOEBachelor's degree and 8+ years LTC claim adjudication experience; ICA or LOMA designations preferred; strong client-facing, audit, analytical, and communication skills.
2d
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Asylum Officer
San Francisco or Tampa or Atlanta or Metairie or Boston or Newark or Bethpage
$62k-$145k/yr OnsiteFull Time
1+ YOEU.S. citizenship, specialized immigration adjudication experience, Secret clearance eligibility, drug screening, background investigation, and strong analytical, writing, communication, and decision-making skills.
USA Hire, USAJOBS, Microsoft Excel
3d
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Specialty Pharmacy Navigator
Atlanta or Gordon
HybridFull Time
5+ YOEUnrestricted pharmacist license, 5+ years of community, retail, ambulatory, or health-system pharmacy experience, Microsoft Office proficiency, dispensing-system and insurance adjudication experience.
Microsoft Office, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Electronic Medical Records (EMR)
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Claims Examiner - Workers Compensation | Dedicated Account | Jurisdiction/Licensing: FL - Required (Remote)
Florida or Memphis or Charlotte or Alabama or Atlanta or Tennessee
RemoteFull Time
5+ YOE5+ years claims experience, high school diploma/GED required, bachelor's preferred, jurisdiction licensing for FL required; strong judgment, analysis, and claims adjudication skills.
2mo
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Amwins A&H- Claims Manager, Stop Loss
Seattle or Atlanta
$140k-$155k/yr RemoteFull Time
10+ YOEBachelor's or equivalent, 10+ years hands-on medical stop loss claims experience, expert contract and claims adjudication knowledge, financial analysis, mentoring experience, and familiarity with Connexure and ESL Office.
Connexure, ESL Office
2mo
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Senior Environmental Claims Adjuster
New York City or Albany or Wyoming or Houston or Washington or District of Columbia or Chicago or Connecticut or Omaha or Alabama or Arizona or Massachusetts or Maryland or Minnesota or North Carolina or Colorado or Connecticut or Florida or Los Angeles or Georgia or Illinois or Maine or New Hampshire or New Jersey or New York or Nevada or Oregon or Pennsylvania or Texas or Washington or Wisconsin or Kansas or Tennessee or New Mexico or Nebraska or Ohio or South Carolina or Virginia or California or Missouri or Arkansas or Indiana or West Virginia or Oklahoma or Rhode Island or Iowa or New Jersey or Illinois or California or New York or Louisiana or Idaho or Texas or Colorado or New Jersey or District of Columbia or Richmond or Utah or California or Connecticut or Massachusetts or New York or Indiana
$121k-$145k/yr OnsiteFull Time
5+ YOEBachelor's degree (or equivalent experience), minimum 5 years adjudicating commercial environmental claims, licensed claims examiner (or ability to obtain), strong negotiation, communication and analytical skills, proficient with Microsoft Office.
Microsoft Office
1w
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Field Service Representative Analyst (FT Gordon, GA)
Augusta, Georgia, United States
$110k-$120k/yr FieldFull Time
Engineering background; proficiency in Java, C++, Python, or JavaScript; experience with Gotham and Gaia; troubleshooting skills; U.S. citizenship; current TS clearance adjudicated within five years; annual 3–6 month deployment.
GHE, Oracle, Postgres, Cassandra, Hadoop, Spark, Java, Groovy, Typescript, React/Redux, Python, AWS, Azure, CentOS, Red Hat Linux, Gotham, Gaia, C++, JavaScript
3w
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Benefits & Claims Specialist, PACE Program, Full-time
Savannah, Georgia, United States
OnsiteMultiple Commitments Available
3+ YOEAssociate degree in finance/business/healthcare admin, knowledge of Medicaid, 3 years medical claims adjudication, 1 year PACE claims experience, valid driver's license and auto insurance, immunizations, and background checks required.
3w
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Medical Case Manager
Warner Robins, Georgia, United States
OnsiteFull Time
Process and manage medical documentation for military aeromedical case adjudication; proficiency with DoD medical systems, medical terminology/ICD-10, strong written/verbal communication, and U.S. citizenship with ability to obtain Tier 1 (NACI) background investigation.
AIMWTS, ECT, PEPP, MEDXS/ASIMS, PSC tracking, Joint Legacy Viewer (JLV), MICT, Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint, PDF
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Sr. Manager, Pricing - Pharmacy Appeals
Arizona or Idaho or Arkansas or Vermont or Georgia or Texas or Minnesota or New Mexico or Montana or Iowa or Michigan or Oregon or Maine or Wisconsin or New York or North Dakota or Kansas or New Jersey or Nebraska or Indiana or Connecticut or Nevada or Rhode Island or Louisiana or Kentucky or Tennessee or Mississippi or Ohio or Oklahoma or West Virginia or Massachusetts or Maryland or South Carolina or Alabama or Missouri or Utah or Virginia or South Dakota or Illinois or North Carolina or Florida or Colorado or Pennsylvania or New Hampshire or Wyoming or Delaware
$68k-$183k/yr RemoteFull Time
7+ YOE5+ Mgmt7 years experience in pricing/PBM/healthcare operations or related domains; 5+ years leading operations teams; 1+ year appeals and claims adjudication experience; Bachelor's degree or equivalent; proficiency with Excel, MS Access, Salesforce; strong analytical and leadership skills.
Microsoft Excel, MS Access, Salesforce, Pharmacy Portal
3w
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Adjudicator 1
Atlanta or Stone Mountain
$49k/yr OnsiteFull Time
3+ YOEReview and analyze medical and vocational evidence to decide disability claims; prepare written decisions; maintain caseloads and ensure compliance with Social Security laws.
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