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Rate Reviewer Jobs in Ridgeway, SC (NOW HIRING)

State of South Carolina

Auditor

Columbia, SC · On-site

Review utility rate case applications for alignment with industry accounting and rate making/regulatory principles. Research and analyze previous rate case decisions and perform financial analysis ...

Skyline Med Staff Therapy

Travel Physical Therapist

Elgin, SC · On-site

$1.6K - $1.9K/wk

Travel Join the Top- Rated Travel Healthcare Team! Skyline Med Staff was named as the #1 Best Travel Healthcare Company in 2025 by BluePipes, a recognition driven by glowing reviews from travel ...

Ourhrconnect

Accountant IV

Columbia, SC · On-site

In this position, you will respond to requests for proposals by developing rates and pricing assumptions, reviewing contract clauses, and preparing supporting documentation for proposal cost elements.

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Showing results 21-40

All JobsRate Reviewer JobsRate Reviewer Jobs in Ridgeway, SC

Rate Reviewer information

See Ridgeway, SC salary details

$10

$28

$46

How much do rate reviewer jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for rate reviewer in Ridgeway, SC is $28.49, according to ZipRecruiter salary data. Most workers in this role earn between $21.54 and $34.86 per hour, depending on experience, location, and employer.

What is the difference between Rate Reviewer vs Claims Adjuster?

AspectRate ReviewerClaims Adjuster
Required CredentialsTypically a high school diploma or equivalent; some roles prefer insurance or finance certificationsHigh school diploma or equivalent; often requires state licensing or certification
Work EnvironmentOffice-based, reviewing insurance rates and policiesField and office-based, investigating and settling insurance claims
Employer & Industry UsageInsurance companies, financial institutionsInsurance companies, public agencies
Comparison Search IntentUnderstanding role differences, job requirements, or career pathsComparing job responsibilities, qualifications, or career options

Both roles are integral to the insurance industry, but a Rate Reviewer primarily evaluates and approves insurance rates, while a Claims Adjuster investigates and settles claims. Understanding these differences helps job seekers identify the right career path based on their skills and interests.

What are the key skills and qualifications needed to thrive as a rate reviewer, and why are they important?

To thrive as a Rate Reviewer, you need strong analytical abilities, attention to detail, and a background in finance, insurance, or a related field—often supported by a bachelor's degree. Familiarity with regulatory compliance tools, actuarial software, and data management systems is typically required. Excellent written communication, objectivity, and organizational skills help you navigate complex regulations and present findings clearly. These competencies ensure accurate rate assessments, regulatory compliance, and effective collaboration with stakeholders.

What is a rate reviewer?

Rate Reviewers are professionals who evaluate and analyze proposed rates, often within industries like insurance, utilities, or healthcare. Their primary responsibility is to ensure that rates set by companies are fair, reasonable, and comply with regulatory standards. They review detailed documentation, financial data, and justifications for rate changes to protect consumer interests and maintain industry transparency. Rate Reviewers often work for government agencies, regulatory bodies, or large organizations.

How much does a rate reviewer make?

A rate reviewer typically earns between $40,000 and $70,000 annually, depending on experience, location, and industry. The role often requires attention to detail and familiarity with financial or insurance data, with some positions offering additional benefits or bonuses.

What are some common challenges faced by rate reviewers and how can they be managed effectively?

Rate Reviewers frequently encounter the challenge of analyzing complex data sets and ensuring compliance with evolving regulatory standards. Staying current with industry regulations and maintaining strong attention to detail are essential for success. Effective collaboration with actuaries, underwriters, and regulatory agencies also helps to resolve discrepancies and ensure accurate rate filings. Developing strong analytical and communication skills can help Rate Reviewers address these challenges and contribute to the organization's compliance and profitability.
Rate Reviewer jobs near you
Infographic showing various Rate Reviewer job openings in Ridgeway, SC as of June 2026, with employment types broken down into 2% As Needed, 83% Full Time, 5% Part Time, 9% Contract, and 1% Nights. Highlights an 57% Physical, 3% Hybrid, and 40% Remote job distribution, with an average salary of $59,258 per year, or $28.5 per hour.

Quality Medical Auditor

BlueCross BlueShield of South Carolina

Columbia, SC • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

BlueCross BlueShield of South Carolina rating

7.5

Company rating: 7.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

217th of 304 rated insurance

Job description

Summary
Performs validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events (serious, preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
Description
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Position Purpose:
Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
Location:
This role is located at 2401 Faraway Drive, Columbia, SC 29229. There is the potential for remote work.
What You'll Do:
  • Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates.
  • Manages records retrieval, release, HIPAA compliance, and all aspects of document management.
  • Serves as expert resource on methodology and procedures for medical records and coding issues.

To Qualify For This Position, You'll Need The Following:
  • Required Education: Associate's in a job related field
  • Degree Equivalency: Graduate of Accredited School of Nursing
  • Required Work Experience: 3 years medical record management to include coding and validation review experience.
  • Skills and Abilities: Excellent verbal and written communication, organizational, customer service, and analytical or critical thinking skills. Good judgment. Ability to handle confidential or sensitive information with discretion. Extensive medical records and coding knowledge. Working knowledge of contract evaluations, claims processing and adjudication practices.
  • Required Licenses and Certificates: Registered Records Administrator or Technician, OR, active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR Certified Coding Specialist.

Our Comprehensive Benefits Package Includes The Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.

What BlueCross BlueShield of South Carolina employees say

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BlueCross BlueShield of South Carolina logo

About BlueCross BlueShield of South Carolina

Sourced by ZipRecruiter

BlueCross BlueShield of South Carolina, headquartered in Columbia, SC, USA, is a major stakeholder in the country's healthcare sector. The company holds the distinction of being one of the largest health insurers in South Carolina. As an independent licensee of the BlueCross BlueShield Association, it offers an extensive range of health insurance products and services, focusing not just on medical coverage, but also on dental, vision, and other supplementary health options. The company was founded in 1946 and has since established itself as a trusted leader in the health sector, committed to affordability, accessibility, and customer service. Their mission is to ensure that all South Carolinians have access to high-quality healthcare and exemplify the core values of accountability, transparency, and commitment to customer satisfaction.

Industry

Insurance services

Company size

10,000+ Employees

Headquarters location

Columbia, SC, US

Year founded

1946

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