RN Clinical Appeals Analyst: Medical Necessity Expert
Remote / Online - Candidates ideally in
Sumter, Sumter County, South Carolina, 29153, USA
Listed on 2026-06-26
Sumter, Sumter County, South Carolina, 29153, USA
Listing for:
CGS Administrators LLC
Full Time, Remote/Work from Home
position Listed on 2026-06-26
Job specializations:
-
IT/Tech
Job Description & How to Apply Below
CGS Administrators LLC is hiring a full-time Appeals Analyst to join Blue Cross Blue Shield of South Carolina. This role requires thorough research on complex appeal requests and clinical reviews to ensure compliance with medical necessity guidelines. The position will be based in either a home-office or on-site environment.
Job qualifications include an associate's degree, RN license, and relevant experience in clinical or medical review. Employees enjoy various benefits including health plans, 401(k), paid leave, and tuition assistance.
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