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Insurance Case Manager Jobs in Rome, GA (NOW HIRING)

AdventHealth

Wound Care RN

Rome, GA · On-site

$30.40 - $49.93/hr

Communicates efficiently with partners outside the department, such as home health nurses, insurance case managers, and referring physicians. * Manages assigned clinics proactively to provide ...

AdventHealth Redmond

Wound Care RN

Rome, GA

$30.40 - $49.93/hr

Communicates efficiently with partners outside the department, such as home health nurses, insurance case managers, and referring physicians. * Manages assigned clinics proactively to provide ...

Affinity Hospice

RN Case Manager-Full Time

Rome, GA · On-site

Must be a licensed driver with an automobile that is insured in accordance with state and/or ... Case manages and provides clinical direction to the interdisciplinary team, physician, and family.

Affinity Hospice

RN Case Manager-Full Time

Rome, GA · On-site

Must be a licensed driver with an automobile that is insured in accordance with state and/or ... Case manages and provides clinical direction to the interdisciplinary team, physician, and family.

AdventHealth

RN Inpatient Wound Ostomy Days

Rome, GA · On-site

$30.40 - $49.93/hr

Communicates efficiently with partners outside the department, such as home health nurses, insurance case managers, and referring physicians. Manages assigned clinics proactively to provide efficient ...

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Insurance Case Manager information

See Rome, GA salary details

$32.5K

$50.9K

$74K

How much do insurance case manager jobs pay per year?

As of Jun 3, 2026, the average yearly pay for insurance case manager in Rome, GA is $50,865.00, according to ZipRecruiter salary data. Most workers in this role earn between $39,000.00 and $59,000.00 per year, depending on experience, location, and employer.

What Is an Insurance Case Manager?

An insurance case manager’s duties are to ensure the delivery of health care benefits or other forms of insurance and related services to their clients and to oversee their clients’ cases. As an insurance case manager, you can work in a variety of settings but usually for insurance carriers and HMOs. Your responsibilities differ depending on who your employer is and the type of insurance you work with. For example, if you work for a life insurance company, your duties involve assessing risk, processing new application paperwork, and other tasks similar to that of an underwriter.

What are the key skills and qualifications needed to thrive as an Insurance Case Manager, and why are they important?

To thrive as an Insurance Case Manager, you need a solid understanding of insurance policies, case management practices, and regulatory compliance, often supported by a bachelor’s degree in a related field and relevant certifications such as Certified Case Manager (CCM). Familiarity with claims management software, customer relationship management (CRM) systems, and medical terminology is typically required. Strong communication, organizational, and problem-solving skills help you effectively coordinate between clients, providers, and insurers. These competencies are crucial for ensuring accurate case evaluations, timely claims processing, and high-quality client service.

How does an Insurance Case Manager typically collaborate with other departments to ensure smooth claim processing?

Insurance Case Managers frequently work with underwriters, claims adjusters, customer service representatives, and sometimes medical professionals to gather necessary information and resolve complex cases. They act as a central point of communication, ensuring all parties are aligned and that documentation is complete and accurate. This collaboration helps streamline claim evaluations, address any discrepancies swiftly, and deliver timely resolutions for clients. Strong teamwork and clear communication are essential for success in this role.

What does an Insurance Case Manager do?

An Insurance Case Manager coordinates and manages insurance claims on behalf of clients, ensuring that cases are processed efficiently and accurately. They review claims, gather necessary documentation, communicate with policyholders, healthcare providers, and insurance companies, and advocate for the best possible outcomes. Their role often involves assessing coverage, resolving issues, and helping clients understand their insurance benefits and options. By serving as a liaison, they streamline the claims process and support clients throughout their case.

What is the difference between Insurance Case Manager vs Claims Adjuster?

AspectInsurance Case ManagerClaims Adjuster
CredentialsCertifications like CPCU or ARM often preferredAdjuster licenses required by state
Work EnvironmentOffice-based, client interaction, case managementField or office-based, claims investigation
Employer & IndustryInsurance companies, healthcare providersInsurance companies, third-party administrators
Search & Comparison IntentManaging claims, coordinating benefitsEvaluating and settling claims

While both roles work within the insurance industry, Insurance Case Managers focus on coordinating benefits and managing ongoing cases, often requiring certifications like CPCU. Claims Adjusters primarily investigate and settle claims, often working in the field. Understanding these differences helps job seekers identify the right career path based on their skills and interests.

More about Insurance Case Manager jobs
What job categories do people searching Insurance Case Manager jobs in Rome, GA look for? The top searched job categories for Insurance Case Manager jobs in Rome, GA are:
What cities near Rome, GA are hiring for Insurance Case Manager jobs? Cities near Rome, GA with the most Insurance Case Manager job openings:
Insurance Case Manager jobs near you
Infographic showing various Insurance Case Manager job openings in Rome, GA as of May 2026, with employment types broken down into 73% Full Time, 19% Part Time, and 8% Contract. Highlights an 100% In-person job distribution, with an average salary of $50,865 per year, or $24.5 per hour.

Clinical Case Manager/MDS

Paulding Care Center for Nursing and Rehabilitation

Dallas, GA

Full-time

Posted 3 days ago

Job description

Job Title: Clinical Case Manager – Utilization Review

Role Overview:
We are seeking a highly organized and detail-oriented Case Manager/MDS to manage the intersection of clinical care and financial reimbursement. This role is primarily focused on managing insurance authorizations, coordinating with the interdisciplinary care team, and ensuring that our billing office has the precise information needed for seamless revenue cycles.

Key Responsibilities

  • Insurance Authorization Management:

    • Work with admissions department to proactively obtain and track initial and ongoing authorizations for all insurance plan.

    • Monitor "next review dates" and submit timely clinical updates to payers to prevent denials.

    • Serve as the primary point of contact for insurance case managers.

  • Care Team Coordination:

    • Participate in weekly meetings with nursing, therapy, and social work to ensure plans of care align with insurance requirements.

    • Attain necessary clinical documentation from team to track progress and submit to plans as required.

  • Billing & Financial Liaison:

    • Work closely with the Business Office Manager and billing department to verify coverage and resolve technical denials.

    • Maintain a systematic log of all authorizations, appeals, and clinical reviews to ensure the billing office has real-time data.

  • Administrative Oversight:

    • Manage a high volume of digital files, ensuring all physician orders and therapy notes are organized and accessible.

    • Maintain meticulous records of phone conversations and email correspondence with payers.

    • Track all necessary information on each case for timely and efficient billing.

Required Qualifications & Skills

  • Systematic Organization: You must have a proven ability to manage multiple deadlines and track complex data points without items falling through the cracks.

  • Technical Proficiency: Computer skills are essential, including experience with Electronic Medical Records (EMR) and Microsoft Excel/Google Sheets.

  • Professional Communication: Excellent phone etiquette and the ability to advocate firmly but professionally with insurance companies.

  • Clinical Knowledge: A background in long-term care, skilled nursing setting is required. A Nurse or a Social Worker (LSW) with heavy experience in utilization review and medical terminology is preferred.

Why You’ll Excel in This Role

You enjoy "putting the puzzle pieces together." You find satisfaction in keeping a clean, organized digital workspace and ensuring that the hard work of the clinical team is accurately reflected in the facility’s financial health as you advocate for your residents.

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