BlueCross BlueShield of South Carolina

📍 Location: South Carolina, None specified, United States

📍 Location: Alabama, None specified, United States

📍 Location: Georgia, None specified, United States

📍 Location: North Carolina, None specified, United States

📍 Location: Tennessee, None specified, United States

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BlueCross BlueShield of SC is an insurance company with the highest A.M. Best rating, deeply rooted in South Carolina.

Medical Review Supervisor - Palmetto GBA

2 days ago

🛢️ Workday

⏰ Full Time

💻 Hybrid

🟡 Junior (5 Years)

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✍️ Full Description

Join the BlueCross BlueShield of South Carolina family of companies and work as a Medical Review Supervisor for Palmetto GBA, a leading provider of high-volume claims and transaction processing. This full-time work-from-home opportunity involves supervising a team of medical reviewers, ensuring the appropriate level of care is provided within established medical guidelines, and identifying fraud and abuse of the Medicare system.

Requirements

Associate's degree in a job-related field or equivalent degree
Five years of clinical nursing or five years of utilization review/medical review experience
One year of team lead/leadership role or equivalent military experience
Active, unrestricted RN licensure from the United States and in the state of hire
Microsoft Office proficiency
Excellent computer and time management skills