Palmetto GBA, a BlueCross BlueShield subsidiary, seeks an RN for a remote, full-time medical claim review role. You will evaluate claims using clinical guidelines, determine medical necessity, and document the rationale for payments or denials in accordance with contractor standards.
Requires an active RN license, 2 years of RN experience, and proficiency with Microsoft Office. Training begins 10/12/2026; preferred residing in SC or AL.
#J-18808-LjbffrRN Medical Reviewer II: Claims & Utilization Expert in northern at Unknown Company
This position is listed as contract and able to be worked remotely.