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Healthcare Nursing

Remote RN Medical Review Specialist - Claims & Utilization

Remote / Online - Candidates ideally in
Kahului, Maui County, Hawaii, 96732, USA
Listing for: BlueCross BlueShield of South Carolina
Remote/Work from Home position
Listed on 2026-03-04
Job specializations:
  • Healthcare
    Healthcare Nursing
Salary/Wage Range or Industry Benchmark: 80000 - 100000 USD Yearly USD 80000.00 100000.00 YEAR
Job Description & How to Apply Below
A major healthcare insurance provider is seeking an experienced Registered Nurse to perform medical reviews. This role requires an active RN license and at least two years of clinical nursing experience. Responsibilities include reviewing medical claims, educating staff on coverage determinations, and participating in quality control activities. The position offers a comprehensive benefits package and involves working hours from 8:00 a.m. to 4:30 p.m. CT, Monday through Friday.
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