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Role Overview:
- Review medical records to determine necessity for benefits and appeals.
- Document decisions using clinical guidelines and support claims.
Work Arrangement:
- On-site in Myrtle Beach, SC for six months of training, then remote.
- Monday-Friday, 8am-5pm with nights, weekends, and holidays off.
Qualifications:
- Active LPN/LVN or LBSW license with two years of clinical experience.
- Proficiency in Microsoft Office and strong analytical and customer service skills.
Palmetto GBA
Palmetto GBA is a healthcare administrator and one of the nation's largest medical claims processors. As part of BlueCross BlueShield of South Carolina, we've served clients for 70+ years and offer training and tuition assistance.