BlueCross BlueShield of South Carolina

BlueCross BlueShield of South Carolina

πŸ“ Location: South Carolina, Myrtle Beach, United States

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

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Medical Reviewer I

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3 days ago
πŸ›’οΈ Workday
⏰ Full Time
πŸ’» Hybrid
🟒 Entry level (2 Years)
🩺 Healthcare Services Jobs
πŸ’° Finance
✍️ Full Description
Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices.

Requirements

  • 2 years of clinical experience
  • Bachelor's degree - Social Work, OR, Graduate of an Accredited School of Licensed Practical Nursing or Licensed Vocational Nursing
  • Active, unrestricted LPN/LVN licensure from the United States and in the state of hired, OR, active compact multistate unrestricted LPN license as defined by the Nurse Licensure Compact (NLC), OR, active, unrestricted LBSW (Licensed Bachelor of Social Work) licensure from the United States and in the state of hire
  • Working knowledge of word processing software
  • Good judgment skills
  • Demonstrated customer service and organizational skills
  • Demonstrated proficiency in spelling, punctuation, and grammar skills
  • Analytical or critical thinking skills
  • Ability to handle confidential or sensitive information with discretion
  • Ability to remain in a stationary position and operate a computer
  • Microsoft Office

Benefits

  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more
πŸ”Ž Search all JobsAll Jobs at BlueCross BlueShield of South Carolina
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