
10,000+ employees
Founded 1946
🏥 Healthcare
💼 Consulting
⚖️ Legal
Healthcare • Consulting • Legal
BlueCross BlueShield of South Carolina is a leading health insurance provider that offers a variety of health plans, including individual and family plans, Medicare options, and group health plans. The organization focuses on providing coverage and resources for members, employers, and healthcare providers, ensuring access to quality healthcare services. With a commitment to promoting healthier lifestyles and supporting community health, BlueCross BlueShield of South Carolina plays a vital role in the healthcare landscape of the region.
Selected: 🆕 Date Added.
🕒 Yesterday
Managed Care Coordinator reviewing medical necessity, benefits, and authorizations for BlueCross BlueShield health plan members. Supporting care management, claims accuracy, and member education remotely in South Carolina.
🕒 Yesterday
Appeals Analyst conducting clinical and benefit reviews for Palmetto GBA, a BlueCross BlueShield South Carolina subsidiary. Documenting compliant decisions on complex healthcare appeals and retrospective reviews.
🕒 5 days ago
RN medical reviewer evaluating complex claims, medical necessity, and coverage decisions for BlueCross BlueShield’s Palmetto GBA. Remote role supporting CMS healthcare claims operations.
🏈 Alabama, North Carolina, +2 more states – Remote
⏰ Full Time
🟢 Junior
🟡 Mid-level
🔍🏥 Medical Reviewer
👻 Ghost score 10%
🕒 August 14
Medical Reviewer assessing complex, preauthorization, appeal, fraud, and coding claims for BlueCross BlueShield of South Carolina. Determining medical necessity and reimbursement using clinical guidelines.
🏈 Alabama, South Carolina, +1 more states – Remote
⏰ Full Time
🟢 Junior
🟡 Mid-level
🔍🏥 Medical Reviewer
👻 Ghost score 20%
🕒 August 6
Behavioral health case manager coordinating intensive care management for South Carolina Medicaid members. Conducting in-person assessments, patient visits, and care coordination across the Low-Country region.
🕒 August 5
Medical Director overseeing utilization review, medical policy, and provider guidance for BlueCross BlueShield’s health insurance and government-contract operations. Researching procedures, analyzing claims data, and supporting medical and regulatory decisions.
🌺 Hawaii, South Carolina, +2 more states – Remote
⏰ Full Time
🔴 Lead
👨⚕️ Medical Director
👻 Ghost score 14%
🕒 July 2
Medicare cost reporting auditor conducting financial, compliance, and operational audits for BlueCross BlueShield of South Carolina. Evaluating controls, detecting fraud, and reporting recommendations to executive management.
🌺 Hawaii, South Carolina, +2 more states – Remote
💵 $49.4k - $94.7k / year
⏰ Full Time
🟢 Junior
🟡 Mid-level
🔎 Auditor
👻 Ghost score 33%