About this role
Medical Reviewer III - Home Health and Hospice at BlueCross BlueShield of South Carolina. Location: Nashville or Georgia or Vermont or Utah or Texas or Washington or Idaho or Virginia or West Virginia or Wyoming or Wisconsin or Illinois or Arkansas or California or Colorado or Connecticut or Delaware or Kentucky or Maine or Maryland or Indiana or Minnesota or Michigan or Iowa or Massachusetts or Kansas or Mississippi or Missouri or Montana or Nevada or Nebraska or New Jersey or Louisiana or New Hampshire or New Mexico or New York or North Carolina or South Carolina or South Dakota or North Dakota or Ohio or Oklahoma or Oregon or Pennsylvania or Rhode Island or Alabama or Arizona or Florida or Tennessee. Role: reviewing claims, documenting rationale, educating staff Requirements: Active unrestricted RN license, Associate degree or nursing graduate, 3+ years clinical or equivalent (2 clinical +1 utilization), working knowledge of managed care, medical review experience, Microsoft Office proficiency. Category: Healthcare Services - Advanced Practice Seniority: Mid Level Tools: Microsoft Office, Microsoft Excel, Microsoft Access Commitment: Full Time Workplace: Remote Languages: English