RN Appeals Analyst (W@H SC or GA)
BlueCross BlueShield of South Carolina · United States · US
Utilization Review
Remote
Nurse
Dentist
Demand78
Career growth64
Healthcare fit84
Remote potential95
5-year outlook
Payer utilization-review and appeals roles tend to offer stable compensation with moderate growth; advancement may come through appeals leadership, quality/compliance, or broader utilization management. Exact salary depends on market, licensure, and experience.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-27
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse, Dentist
- Rate period
- Annual
Why this was classified this way
- contractor
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
A solid option for RNs interested in remote payer utilization review who want predictable hours and clinical-adjacent work without direct patient care. Less suitable for nurses seeking clinical practice, bedside work, or roles open to candidates outside SC/GA.
Who should apply
RNs with utilization review, medical review, quality assurance, home health, or broad medical-surgical experience who live in South Carolina or Georgia and want a remote payer appeals role. Nurses with compact multistate licenses may also be well positioned.
CV angle
Frame bedside and clinical experience around medical necessity review, clinical documentation interpretation, independent decision-making, managed care exposure, quality assurance, regulatory compliance, and communication with providers/members. Emphasize any utilization review, appeals, case review, HIPAA, or payer-facing work without overstating experience.
Skills to highlight
- Clinical review
- Medical necessity determination
- Utilization review
- Appeals and retrospective review
- Clinical documentation analysis
- Managed care knowledge
- Regulatory and HIPAA compliance
- Independent decision-making and communication
Role summary
Remote RN appeals analyst role at a BlueCross BlueShield payer, researching complex provider and member appeals, performing clinical or benefit reviews, documenting decisions within required timeframes, and applying medical necessity and managed care guidelines.
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