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RN Medical Reviewer II – Claims & Utilization
Job in
North Charleston, Charleston County, South Carolina, 29405, USA
Listed on 2026-08-18
Listing for:
033 Palmetto GBA
Full Time
position Listed on 2026-08-18
Job specializations:
-
Nursing
RN Nurse
Job Description & How to Apply Below
Palmetto GBA, a Blue Cross Blue Shield of South Carolina subsidiary, seeks an experienced RN reviewer to perform medical claim reviews and determine medical necessity using established criteria and guidelines. This full-time role involves preauthorization, appeals, and education for internal staff.
Ideal candidates hold an active RN license, an associate degree or higher, and at least two years of clinical RN experience with strong analytical and communication skills.
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