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Manager Adjudication Jobs in Georgia (NOW HIRING)

Compass Medical Provider

Medical Case Manager

GA · On-site

$28/hr

... adjudication. - Enter and update case status across Air Force and DoD systems of record - **AIMWTS, ECT, PEPP, MEDXS/ASIMS**, and PSC tracking - keeping every record current as case status changes ...

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Manager Adjudication information

What are the roles and responsibilities of a manager adjudication?

A Manager Adjudication oversees the process of reviewing and making decisions on claims, disputes, or applications, often within insurance, healthcare, or government sectors. Their responsibilities include managing a team of adjudicators, ensuring compliance with policies and regulations, reviewing complex cases, and implementing process improvements. They also provide training and support to staff, handle escalated cases, and work to streamline adjudication procedures for efficiency and fairness.

What are the key skills and qualifications needed to thrive as a manager adjudication?

To thrive as a Manager Adjudication, you need strong analytical skills, deep knowledge of claims processing, and typically a bachelor’s degree in business, healthcare administration, or a related field. Familiarity with adjudication software, claims management systems, and regulatory compliance tools is essential. Leadership, effective communication, and problem-solving abilities are crucial soft skills for managing teams and complex case reviews. These competencies ensure accurate, timely claims decisions and maintain compliance with industry standards, directly impacting organizational efficiency and client satisfaction.

What are some common challenges faced by a manager adjudication, and how can they be addressed?

A Manager Adjudication often faces challenges such as managing high volumes of complex cases, ensuring consistent and fair decision-making, and keeping up with changing regulations or organizational policies. Balancing efficiency while maintaining accuracy can be demanding, especially when deadlines are tight. These challenges can be addressed by implementing robust training programs for staff, leveraging technology for workflow management, and fostering clear communication within the team to ensure everyone is aligned on best practices and updates.

What is the difference between Manager Adjudication vs Claims Supervisor?

AspectManager AdjudicationClaims Supervisor
CredentialsTypically requires insurance or healthcare certifications, relevant degreesSimilar credentials, often with insurance or healthcare background
Work EnvironmentOffice-based, insurance or healthcare settingOffice-based, insurance or healthcare setting
Industry UsageCommon in insurance, healthcare, and claims processingCommon in insurance, healthcare, and claims departments
Primary FocusReviewing and approving claims, making adjudication decisionsOverseeing claims processing, managing claims staff

While both roles operate within the insurance and healthcare industries, the Manager Adjudication primarily focuses on reviewing and making decisions on claims, whereas the Claims Supervisor manages the claims team and oversees the claims process. Both roles require similar credentials and work environments, but their core responsibilities differ in scope and focus.

What are the most commonly searched types of Adjudication jobs in Georgia?

The most popular types of Adjudication jobs in Georgia are:

What are popular job titles related to Manager Adjudication jobs in Georgia?

For Manager Adjudication jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Manager Adjudication jobs in Georgia look for?

The top searched job categories for Manager Adjudication jobs in Georgia are:

What cities in Georgia are hiring for Manager Adjudication jobs?

Cities in Georgia with the most Manager Adjudication job openings:

Manager Adjudication jobs near you
Infographic showing various Manager Adjudication job openings in Georgia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 87% In-person, and 13% Remote job distribution.

Medical Case Manager

Warner Robins, GA • On-site

French Consulting
See more jobs at French Consultingexternal

Full-time

Posted 14 days ago

Job description

We are looking for individuals who want to join our team at Robins Air Force Base, Georgia.
Apply now!
Job Opportunity: Medical Case Manager
Location: Headquarters Air Force Reserve Command, Robins Air Force Base, Georgia
Start Date: Upon Contract Award / Phase-In Completion
Schedule: Full-time, with part-time Co-Work and PTOC options available
Make a Difference Behind the Mission
Are you detail-driven and comfortable moving through a high volume of case files without losing accuracy? Do you want your work to directly support the medical readiness of nearly 70,000 Air Force Reservists?
French Consulting is seeking Medical Case Managers to process aeromedical and non-flying medical cases for the Aerospace and Operational Medicine Division at Headquarters Air Force Reserve Command, Robins Air Force Base. You'll review medical case files, track them through adjudication, and keep reserve units informed at every step.
What You'll Do
  • Update case status in AIMWTS, ECT, PEPP, and other systems of record as case status changes.
  • Provide written instructions to reserve medical units on incomplete or questionable case documentation.
  • Apply general medical guidelines covering physical standards to help adjudicate medical cases, and obtain medical opinions from professional medical personnel when needed.
  • Coordinate with Major Commands, Headquarters Air Force, and Military Treatment Facilities on reserve-specific medical issues.
  • Confirm all required data is included in case files before submission for provider adjudication.
  • Load cases into the appropriate electronic system of record and complete technician-level front- and back-end case management.
  • Track each case through the full review process, keeping Reserve Medical Units and the Chief, Medical Standards, informed of status.
  • Coordinate and assist with scheduling evaluations through the Aeromedical Consult Service, the nearest Military Treatment Facility, and outside civilian agencies.
  • Review, schedule, and certify accession, retention, and flying waivers using ECT, AIMWTS, and PEPP.
  • Compile data for final case disposition and mail completed case results to the member.
  • Some Medical Case Manager positions are part-time Co-Work billets, committed at up to 20 hours a week with the potential to scale toward a full 40-hour week if surge work is authorized; we also credential Part-Time On-Call (PTOC) partners who share a caseload with a full-time Medical Case Manager, meeting the same qualification standard.
Who You Are
  • You keep your composure when the queue is long and the deadline hasn't moved.
  • You read a medical file for what's missing, not just what's there.
  • You document your work the same way every time, so anyone can pick it up after you.
  • You ask for a second opinion when adjudication guidance is unclear, instead of guessing.
Qualifications
Required
  • Demonstrated case-management/adjudication experience, including processing and managing physical exams and medical standards, gained in a military medical environment or an equivalent civilian aeromedical, occupational health, or disability evaluation system.
  • Working knowledge of, or demonstrated ability to rapidly acquire proficiency in, AIMWTS, PEPP, Periodic Health Assessment programs, Joint Legacy Viewer, Management Internal Control Toolset, Salesforce, Moveit CIB, MyFSS, and BOMC KX.
  • Working knowledge of medical standards for retention, flying classes, and Line of Duty determinations, including the Aeromedical Waiver Guide and the Medical Standards Directory.
  • Basic knowledge of anatomy, physiology, and human body systems, plus working knowledge of medical terminology and ICD-10 coding.
  • Strong customer service and oral and written communication skills.
  • Proficiency with PDF software and the Microsoft Office Suite, plus proficient typing skills.
  • Able to obtain and maintain a favorable Tier 1 background investigation or equivalent.
Preferred
  • Prior experience in a military or federal health care administrative role.
  • Familiarity with the Disability Evaluation System or a comparable case-adjudication process.
Education & Certifications
Required
  • Bachelor's degree in nursing, social work, health administration, or a related field; or, in lieu of a degree, equivalent case-management/adjudication experience gained in a military or civilian medical-standards environment (per the PWS's domain-experience equivalency standard - no specific degree or license is mandated by the performance work statement).
Desired
  • Active professional license or certification such as Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), or Certified Case Manager (CCM).
Why You'll Love It Here
  • Your work keeps reserve units across three Numbered Air Forces medically ready.
  • Full-time or part-time Co-Work schedules available, Monday through Friday within 0800 to 1600 Eastern; full-time staff receive federal holidays and Family/Down Days off.
  • On-site at Robins Air Force Base, with situational telework available once approved.
  • Structured onboarding: you'll shadow the team performing this work before you take a caseload of your own.
Ready to Join Us?
If you're ready to put your attention to detail to work supporting Air Force Reservists, we'd love to hear from you. Apply today and bring your accuracy, focus, and dedication to a team that counts on it.
Equal Opportunity & Legal Notices (Georgia)
French Consulting is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Employment with French Consulting is at-will, consistent with Georgia law: either party may end the employment relationship at any time, for any lawful reason not prohibited by law. French Consulting participates in E-Verify and confirms the employment eligibility of every newly hired employee through the federal E-Verify system, consistent with Georgia's Illegal Immigration Reform and Enforcement Act (O.C.G.A. § 13-10-91).
French Consulting is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.

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