RN Medical Reviewer II — Claims & Utilization Expert
Southcarolinablues
BlueCross BlueShield of South Carolina is seeking a registered nurse to perform utilization review for medical claims in a home-office setting. The role includes evaluating complex services, preauthorizations, and appeals while ensuring accurate coding and reimbursement. The candidate will determine medical necessity, document rationale, and educate internal staff on review processes, coding, and guidelines. #J-18808-Ljbffr Southcarolinablues
Vacancy posted 2 days ago
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