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Case Reviewer Jobs in Georgia (NOW HIRING)

JAMS, Inc.

Case Coordinator

Atlanta, GA · On-site

$49K - $64K/yr

Coordinates case administration and case management within the case management team. Provides ... Reviews closed cases to determine client satisfaction and future business opportunities. * Other ...

Encompass Health

Case Manager

Savannah, GA

$18.75 - $24/hr

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health

Case Manager

Loganville, GA

$19 - $24.50/hr

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health

Case Manager

Newnan, GA · On-site

$18 - $23.25/hr

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

JAMS, Inc.

Case Coordinator

Atlanta, GA · On-site

$18.50 - $25/hr

Coordinates case administration and case management within the case management team. Provides ... Reviews closed cases to determine client satisfaction and future business opportunities. * Other ...

Encompass Health Corporation

Case Manager

Athens, GA · On-site

$17.50 - $22.50/hr

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

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Case Reviewer information

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$16

$40

$67

How much do case reviewer jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for case reviewer in Georgia is $40.14, according to ZipRecruiter salary data. Most workers in this role earn between $29.86 and $48.51 per hour, depending on experience, location, and employer.

How to get a job as a case reviewer?

To become a case reviewer, candidates typically need a background in healthcare, social work, or legal fields, along with strong analytical and communication skills. Relevant experience, attention to detail, and familiarity with case management systems or documentation are often required, and some positions may require certification or training in specific areas.

What are the key skills and qualifications needed to thrive in the case reviewer position, and why are they important?

To thrive as a Case Reviewer, you need strong analytical abilities, attention to detail, and a background in the relevant industry, often supported by a degree in law, healthcare, or a specialized field. Familiarity with case management software, electronic records systems, or regulatory databases is usually important, and certifications may be required for specialized roles. Excellent written communication, impartiality, and time management are soft skills that set top performers apart. Mastery of these skills ensures accurate, timely case evaluations and effective collaboration with stakeholders for informed decision-making.

What is a case reviewer?

A Case Reviewer is responsible for evaluating case files, documents, and related information to ensure accuracy, compliance, and completeness. They analyze evidence, verify facts, and provide detailed assessments based on established guidelines or legal standards. Case Reviewers often work in legal, medical, insurance, or government sectors and must have strong attention to detail and analytical skills. Their role helps ensure fair and accurate decision-making in various professional settings.

What are the typical daily responsibilities of a case reviewer?

As a Case Reviewer, your day-to-day work commonly involves reviewing case files, supporting documents, and related evidence to assess compliance with relevant guidelines or policies. You may be required to write detailed reports, summarize findings, and make recommendations based on established criteria. Collaboration is frequent, as you often interact with other reviewers, supervisors, and subject matter experts to discuss complex cases or clarify information. This role demands a high level of organization and consistency, as accuracy and fairness are critical when determining outcomes that impact clients, patients, or other stakeholders.

What does a case reviewer do?

A case reviewer evaluates and analyzes cases, such as insurance claims, legal matters, or healthcare records, to ensure accuracy, completeness, and compliance with policies. They often review documentation, make determinations, and document findings, using attention to detail and sometimes specialized software or guidelines.
What are the most commonly searched types of Case Reviewer jobs in Georgia? The most popular types of Case Reviewer jobs in Georgia are:
What are popular job titles related to Case Reviewer jobs in Georgia? For Case Reviewer jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Case Reviewer jobs in Georgia look for? The top searched job categories for Case Reviewer jobs in Georgia are:
What cities in Georgia are hiring for Case Reviewer jobs? Cities in Georgia with the most Case Reviewer job openings:
What are popular job titles related to Case Reviewer jobs in GA? For Case Reviewer jobs in GA, the most frequently searched job titles are:
Case Reviewer jobs near you
Infographic showing various Case Reviewer job openings in Georgia as of August 2026, with employment types broken down into 75% Full Time, 12% Part Time, and 13% Contract. Highlights an 80% In-person, 4% Hybrid, and 16% Remote job distribution, with an average salary of $83,483 per year, or $40.1 per hour.

RN Case Manager

Colquitt Regional Medical Center

Moultrie, GA • On-site

Other

Posted 7 days ago

Colquitt Regional Medical Center rating

5.0

Company rating: 5.0 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

992nd of 1,058 rated hospitals

Job description

Utilization Review Nurse

The Utilization Review nurse works with the multidisciplinary team including physicians, staff and payers to ensure patient's progress along the continuum of care in an efficient and cost-effective manner that ensures quality outcomes. They utilize established guidelines to support appropriate level of care throughout hospitalization. They serve as a liaison between the hospital and external payers on issues related to severity of illness and intensity of service for patients to ensure appropriate and timely utilization of hospital services. The position includes but not limited to basic UR job duties such as level of care determination, clinical submission to payers, timely following/securing of auth payer status, timely discharge notification, monitoring status of procedural cases and submitting/monitoring post acute authorization status.

Admission and Concurrent Case Review:

  • Uses approved criteria for admission and continued stay reviews to ensure appropriate setting and timely implementation of plan of care.
  • Monitors patient's progress across the continuum and intervenes as necessary to ensure quality services that are efficient and cost effective.
  • Collaborates with admitting physician regarding appropriate level of care/status determination.
  • Consults with Physician Advisor and administrative leadership as necessary for those patients not meeting medical necessary services for acute care.
  • Knowledgeable of Medicare, Medicaid and non-governmental payer regulations for patient care requirements.
  • Responds to requested insurance reviews based on contractual obligations.
  • Actively manages concurrent denials.
  • Reports data per request of the appropriate leadership for information and resolution, which may include risk management, epidemiology, payer requirements, and performance improvement departments.
  • Complete timely discharges and final authorization status to ensure alignment of payer auth and claim submission.

Regulatory and Contractual Compliance:

  • Demonstrates service excellence by providing complete clinical information to government and non-governmental review organizations following HIPAA guidelines.
  • Identify and document appropriate necessary changes in level of care.
  • Partners with Case Management for Medicare patients disputing their discharge.
  • Delivery of Detailed Notice of Discharge and transmission of medical records to the QIO within required timeframes.
  • Partners with Case Management for delivery of any regulatory documentation.
  • Documents all pertinent communication regarding certification in clinical database.
  • Timely submission of all initial, concurrent and discharge reviews.
  • Serves as a resource to the healthcare team regarding utilization standards and potential alternatives to acute care hospitalization.
  • Evaluate hospitalized patients to make sure they are receiving services in the most appropriate and cost - effective setting in collaboration with attending physicians.
  • Additional responsibilities as needed.
Qualifications

Behaviors:

Team Player:

Works well as a member of a group

Detail Oriented:

Capable of carrying out a given task with all details necessary to get the task done well

Education:

Required:

Associates or better in Nursing.

Experience:

Required: 5 years:

Previous Case Mgmt / UR experience and/or bedside experience in an acute inpatient hospital.

Preferred:

Swingbed experience a bonus

Licenses & Certifications:

Required:

Registered Nurse

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

What Colquitt Regional Medical Center employees say

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