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Reimbursement Case Manager Jobs in Decatur, GA (NOW HIRING)

Paradigm

Nurse Case Manager - Atlanta, GA

Atlanta, GA · On-site

$85K - $95K/yr

The Surprising Truth About Case Management - Paradigm Watch this short video for a brief ... phone and internet reimbursement, mileage reimbursement (federal rate), 401(k) matching ...

Enlyte

Medical Field Case Manager

Lithia Springs, GA · On-site

$70K - $80K/yr

... reimbursement, Employee Assistance and Referral Program, and hands-on workers' compensation case management training. Join our compassionate team and help make a positive difference in an injured ...

Enlyte

Medical Field Case Manager

Lithia Springs, GA · On-site

$70K - $80K/yr

... reimbursement, Employee Assistance and Referral Program, and hands-on workers' compensation case management training. Join our compassionate team and help make a positive difference in an injured ...

Clarvida

Employment Case Manager

Alpharetta, GA · Hybrid

$24 - $29/hr

As an Employment Specialist/Case Manager, you will work with Medicaid clients aged 16 and older who ... Mileage reimbursement* If you're #readytowork we are #readytohire ! *benefit option varies by State ...

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Reimbursement Case Manager information

See Decatur, GA salary details

$14

$24

$41

How much do reimbursement case manager jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for reimbursement case manager in Decatur, GA is $24.17, according to ZipRecruiter salary data. Most workers in this role earn between $18.80 and $26.30 per hour, depending on experience, location, and employer.

What is a Reimbursement Case Manager?

A Reimbursement Case Manager is a professional who helps patients navigate insurance policies and secure coverage for medical treatments, procedures, or medications. They work closely with healthcare providers, insurance companies, and patients to ensure that claims are processed correctly and efficiently. Their role often includes verifying benefits, appealing denied claims, and assisting with prior authorizations. By managing these complex processes, they help reduce financial barriers to care and improve patient access to necessary treatments.

What is the difference between Reimbursement Case Manager vs Claims Specialist?

AspectReimbursement Case ManagerClaims Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare facilities, insurance companies, or managed care organizationsInsurance companies, third-party administrators, or healthcare providers
Job FocusManaging reimbursement processes, verifying coverage, and resolving billing issuesProcessing claims, reviewing documentation, and ensuring accurate claim submission

Reimbursement Case Managers and Claims Specialists both work within the healthcare and insurance industries, focusing on financial aspects of patient care. While Reimbursement Case Managers primarily handle reimbursement processes and coverage verification, Claims Specialists concentrate on processing and reviewing insurance claims. Both roles require knowledge of insurance policies and healthcare billing, but their daily tasks and focus areas differ slightly.

How does a Reimbursement Case Manager typically collaborate with healthcare providers and insurance companies to resolve patient billing issues?

Reimbursement Case Managers act as key liaisons between healthcare providers, patients, and insurance companies to ensure that claims are processed accurately and efficiently. They regularly communicate with medical staff to collect necessary documentation, clarify coding, and verify treatment details. Additionally, they work closely with insurance representatives to address denials, appeal decisions, and troubleshoot payment delays. This collaborative approach requires strong communication skills and a deep understanding of both clinical and insurance processes.

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

To thrive as a Reimbursement Case Manager, you need a solid understanding of healthcare reimbursement processes, insurance policies, and medical billing, often supported by a background in nursing, social work, or healthcare administration. Familiarity with claims management systems, electronic health records (EHRs), and payer portals is typically required, and certifications like CCM (Certified Case Manager) can be advantageous. Strong communication, problem-solving, and organizational skills help you effectively advocate for patients and collaborate with providers and payers. These competencies ensure accurate reimbursement, compliance, and optimal patient outcomes in a complex healthcare environment.
What are popular job titles related to Reimbursement Case Manager jobs in Decatur, GA? For Reimbursement Case Manager jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Reimbursement Case Manager jobs in Decatur, GA look for? The top searched job categories for Reimbursement Case Manager jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Reimbursement Case Manager jobs? Cities near Decatur, GA with the most Reimbursement Case Manager job openings:
Reimbursement Case Manager jobs near you
Infographic showing various Reimbursement Case Manager job openings in Decatur, GA as of May 2026, with employment types broken down into 2% As Needed, 68% Full Time, 28% Part Time, and 2% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $50,275 per year, or $24.2 per hour.
Sr. Medical Case Manager

Sr. Medical Case Manager

Crawford and Company

Peachtree Corners, GA • On-site, Remote

$26.65 - $48.74/hr

Full-time

Posted 28 days ago

Job description

Job Description
Now Hiring: RN Case Manager - Los Angeles, CA Region
Work from home + local field travel
Salary: $26.65 - $48.74 per hour
Quarterly Bonus Opportunities
Free CEUs for licenses & certificates
License & Certification Reimbursement
We're looking for an RN with a passion for case management to join our team!
RN degree required
National Certification preferred (CCM, CRC, COHN, CRRN)
Workers' Comp Case Management experience a plus
Location Requirement
Candidates must be based in one of these California areas:
San Fernando, Van Nuys, Santa Clarita, Granada Hills, Panorama, Valencia, Oxnard, Westlake Village, Palmdale, or Chatsworth.
✅ Your Impact: You'll provide effective case management services in a cost-effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management.
This is your chance to grow your career, earn great rewards, and enjoy true work-life balance.
Apply today and make an impact in the community!
Responsibilities
  • Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.
  • Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW.
  • Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention.
  • May perform job site evaluations/summaries to facilitate case management process.
  • Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians.
  • Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual.
  • May obtain records from the branch claims office.
  • May review files for claims adjusters and supervisors for appropriate referral for case management services.
  • May meet with employers to review active files.
  • Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians.
  • Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly.
  • May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases.
  • Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.
  • Reviews cases with supervisor monthly to evaluate files and obtain directions.
  • Upholds the Crawford and Company Code of Business Conduct at all times.
  • Demonstrates excellent customer service, and respect for customers, co-workers, and management.
  • Independently approaches problem solving by appropriate use of research and resources.
  • May perform other related duties as assigned.

Qualifications
  • Bachelor's Degree in a health-related field is preferred. Associates or diploma in nursing also accepted.
  • Three years of Workers' Compensation case management with ability to independently coordinate a diverse caseload ranging in moderate to high complexity.
  • Demonstrated ability to handle complex assignments and ability to work independently is required.
  • Effective oral and written communication skills are required.
  • Thorough understanding of jurisdictional WC statutes.
  • Advanced knowledge to exert positive influence in all areas of case management.
  • Advanced communications and interpersonal skills in order to conduct training, provide mentorship, and assist supervisor in general areas as assigned.
  • Highly skilled at promoting all managed care products and services internally and externally.
  • Active RN home state licensure in good standing without restrictions with the State Board of Nursing.
  • Minimum of 1 nationally recognized Certification from the URAC list of approved certifications.
  • Must be able to travel as required.
  • Individuals who conduct initial clinical review possess an active, professional license or certification:
    • To practice as a health professional in a state or territory of the U.S.; and
    • With a scope of practice that is relevant to the clinical area(s) addressed in the initial clinical review.
  • Must maintain a valid driver's license in state of residence.

#LI-RG1
About Us
Why Crawford?
Because a claim is more than a number - it's a person, a child, a friend. It's anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community - one claim at a time.
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We're looking for the next generation of leaders to take this journey with us.
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
When you accept a job with Crawford, you become a part of the One Crawford family.
Our total compensation plans provide each of our employees with far more than just a great salary
  • Pay and incentive plans that recognize performance excellence
  • Benefit programs that empower financial, physical, and mental wellness
  • Training programs that promote continuous learning and career progression while enhancing job performance
  • Sustainability programs that give back to the communities in which we live and work
  • A culture of respect, collaboration, entrepreneurial spirit and inclusion
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.

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