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Medicaid Claims Processing Jobs in Georgia (NOW HIRING)

Conduent, Inc.

Senior Business Analyst (MMIS)

Atlanta, GA · On-site +1

$89K - $114K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Senior Business Analyst - CMdS Claims, Medicaid Enterprise Systems (MES) Experience: 10+ years ... Produce BRDs, FRDs, process flows, data mapping, gap analysis, and configuration workbooks suitable ...

Conduent, Inc.

Business Analyst (MMIS)

Atlanta, GA · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Role summary ... Produce BRDs, FRDs, process flows, data mapping, gap analysis, and configuration workbooks suitable ...

Conduent, Inc.

Business Analyst (MMIS)

Atlanta, GA · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Role summary ... Produce BRDs, FRDs, process flows, data mapping, gap analysis, and configuration workbooks suitable ...

Compunnel

NetworX Configuration Analyst

Thomson, GA · On-site

... complex claims processing. The ideal candidate will have strong expertise in TriZetto Facets ... Medicaid, and regulatory requirements. • Collaborate with Configuration leadership, Claims ...

Verida Inc

Claims Specialist I

Villa Rica, GA · On-site

This role is also charged with communicating with the provider the proper process of filing claims ... Knowledge of Medicaid Non-Emergency Transports preferred. * Able to handle multiple tasks ...

Verida Inc

Claims Specialist I

Villa Rica, GA · On-site

This role is also charged with communicating with the provider the proper process of filing claims ... Knowledge of Medicaid Non-Emergency Transports preferred. * Able to handle multiple tasks ...

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All JobsMedicaid Claims Processing JobsMedicaid Claims Processing Jobs in Georgia

Medicaid Claims Processing information

What is a Medicaid claims processing job?

A Medicaid Claims Processing job involves reviewing, verifying, and processing healthcare claims submitted by providers seeking reimbursement for services rendered to Medicaid beneficiaries. Workers in this role ensure claims comply with state and federal regulations, identify errors or discrepancies, and communicate with healthcare providers to resolve issues. They may also use specialized software to input and track claims, process denials or appeals, and ensure timely and accurate payments. Strong attention to detail, knowledge of Medicaid policies, and proficiency with healthcare billing codes are essential for success in this role.

How to get a job as a Medicaid Claims Processing specialist?

To become a Medicaid Claims Processing specialist, candidates typically need a high school diploma or equivalent, with some roles requiring an associate degree or relevant certification. Experience with healthcare billing, claims processing software, and knowledge of Medicaid policies are important; familiarity with tools like claims management systems can improve job prospects. Applying through healthcare organizations, government agencies, or staffing agencies and demonstrating attention to detail and knowledge of healthcare regulations are key steps.

Is a Medicaid Claims Processing job in demand?

Medicaid Claims Processing jobs are in demand due to the ongoing need for healthcare administration and insurance claims management. These roles often require attention to detail and familiarity with claims processing software, and employment opportunities are expected to grow with the expansion of healthcare programs.

What are some typical challenges faced in Medicaid claims processing, and how can I prepare for them?

One of the main challenges in Medicaid Claims Processing is staying up-to-date with frequently changing policies, billing codes, and compliance requirements, which can vary by state and program. Professionals in this role must pay close attention to detail to avoid errors and denials, often working with tight deadlines and large volumes of claims. To prepare, it's helpful to become familiar with Medicaid guidelines, maintain strong organizational habits, and proactively seek out updates in regulations or coding standards. Collaborating with other team members, such as care coordinators and billing specialists, is essential to ensure claims are accurate and properly documented. Ongoing learning and adaptability are key for long-term success in this dynamic environment.

What are the key skills and qualifications needed to thrive in Medicaid claims processing?

Success in Medicaid Claims Processing requires excellent attention to detail, a thorough understanding of healthcare billing procedures, and familiarity with Medicaid regulations and insurance guidelines. Proficiency in medical billing software, claims management systems, and sometimes industry certifications such as Certified Professional Coder (CPC) is beneficial. Strong organizational skills, problem-solving abilities, and effective written and verbal communication help individuals excel in this role. These skills and qualifications are crucial for ensuring accurate, timely claims processing and compliance with ever-evolving Medicaid requirements.

Is Medicaid claims processing a stressful job?

Medicaid claims processing can be stressful due to the high volume of claims, strict deadlines, and the need for accuracy to prevent errors. Employees often work with detailed data and may experience pressure during busy periods or when resolving complex issues, but proper training and workflow management can help mitigate stress.

What are the most commonly searched types of Medicaid Claims Processing jobs in Georgia?

The most popular types of Medicaid Claims Processing jobs in Georgia are:

What are popular job titles related to Medicaid Claims Processing jobs in Georgia?

For Medicaid Claims Processing jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Medicaid Claims Processing jobs in Georgia look for?

The top searched job categories for Medicaid Claims Processing jobs in Georgia are:

Medicaid Claims Processing jobs near you
Infographic showing various Medicaid Claims Processing job openings in Georgia as of August 2026, with employment types broken down into 33% Full Time, and 67% Part Time. Highlights an 100% In-person job distribution.

Claims Account Representative

Southeastrans

Villa Rica, GA • On-site

Other

Re-posted 2 days ago

Job description

POSITION CONTINGENT UPON CONTRACT AWARD
SUMMARY: Provides excellent customer service to non-emergency Medicaid and MCO transportation providers. Answers calls regarding existing claims status, including handling tasks associated with those claims. Monitors timely receipt of information to contractors/providers. Ensures complete and sound claim settlements and investigations when necessary. Examines records and ensures that transportation providers are paid according to the contractual terms. Maintains the accuracy and confidentiality of data, records, and files. Provides customers/providers with exceptional quality and efficient customer service.
ESSENTIAL FUNCTIONS
  • Answers calls regarding existing claims status
  • Provides first call resolution; working with appropriate internal/external resources, completing the necessary follow-up, and ensuring closure of the inquiry
  • Answers incoming requests in a friendly manner, responds to routine questions; inputs and/or logs information received into the computer equipment; directs requests to the appropriate department or agency for further action.
  • Resolves claims problems by clarifying issues, researching and exploring answers and alternative solutions, implementing solutions, and escalating unresolved problems.
  • Listens and communicates clearly, professionally and empathetically
  • Works from established procedures, scripts and job aids to handle multiple applications while assisting customers on the phone
  • Escalates problems or inquiries as needed
  • Maintains quality, accuracy and professionalism in a fast-paced environment
  • Ability to multi-task and adapt to changing environment
  • Processes claims
  • Able to handle complex claims
  • Must have good understanding of contracts, claims processing, and policies
  • Excellent knowledge of the organization
  • Claims related project work
  • Other duties as assigned
REQUIRED SKILLS AND ABILITIES
  • Professional telephone etiquette including excellent verbal communication skills and use of proper grammar
  • Ability to process information and react quickly and appropriately
  • Strong work ethic and self-starter, able to effectively manage multiple priorities and adapt to change within a fast-paced business environment
  • Excellent listening skills and the ability to ask probing questions, understand concerns, and overcome objections
  • Prior customer service experience
  • Must adhere to HIPAA standards
  • Displays written and verbal communication skills with executive management and staff, and is able to follow written and oral instructions.
  • Ability to process, formulate and modify policies; train and direct staff.
  • Possesses good organizational skills, ability to focus on assigned tasks
  • Able to work collaboratively, diplomatically, and with integrity in identifying and resolving problems.
  • Displays knowledge of ethical principles and compliance issues in an accounting setting.
  • Ability to foster positive working relationships across all departments
  • Able to handle highly confidential and sensitive information
  • Highly organized, displays strong attention to detail and accuracy
  • Ability to multi-task giving attention to deadlines
  • Intermediate level proficiency in Microsoft Word and Excel
  • Ability to work extended hours when workload necessitates
Professional appearanceQUALIFICATION
  • High School diploma.
  • Minimum of 2 years leadership experience
  • Minimum of 3 years of recent (within the last 5 years) claims processing experience
  • Healthcare, Medicaid and MCO, claims experience a plus

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