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Medical Reviewer — Claims & Utilization Specialist
Job in
Myrtle Beach, Horry County, South Carolina, 29588, USA
Listed on 2026-03-01
Listing for:
Southcarolinablues
Full Time
position Listed on 2026-03-01
Job specializations:
-
Healthcare
Healthcare Administration
Job Description & How to Apply Below
A healthcare provider in Myrtle Beach seeks a Medical Claims Review Specialist to conduct detailed reviews and determinations for medical claims. The ideal candidate must hold a Bachelor's degree in Social Work with 2 years of clinical experience and possess current LPN or social work licensure. Key responsibilities include authorizing coverage for medical services, educating members on their benefits, and participating in quality control initiatives.
This role offers benefits like health coverage, 401k plans, and paid time off.
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