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Remote Prior Authorization Rn Jobs in Columbia, SC

Ourhrconnect

Quality Medical Auditor

Columbia, SC · Remote

There is the potential for remote work. What You'll Do: * Determines methodology to identify cases ... Registered Records Administrator or Technician, OR, active, unrestricted RN licensure from the ...

AO ASPIRE

Be Seen First

Remote Sales Rep- NO COLD CALLING

Columbia, SC · Remote

$50K - $120K/yr

... Firefighters, Nurses, and now, Veterans. For over 60 years, we have been the #1 provider of ... No prior experience required! Our industry-leading training and support will equip you with the ...

Air National Guard Units

HR SPEC (MILITARY)

Eastover, SC · On-site +1

$61K - $80K/yr

The position is a remote from the Human Resources Office (HRO) and embedded within the Military ... Defense Authorization Act of 1986 requires that you be registered or you are not eligible for ...

Air National Guard Units

AIRCRAFT ELECTRICIAN

Eastover, SC · On-site +1

$33.12 - $38.63/hr

... prior to applying for this position. * This is an excepted service position that requires ... Defense Authorization Act of 1986 requires that you be registered or you are not eligible for ...

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Showing results 21-40

All JobsPrior Authorization Rn JobsRemote Prior Authorization Rn JobsRemote Prior Authorization Rn Jobs in Columbia, SC

Remote Prior Authorization Rn information

See Columbia, SC salary details

$6

$39

$66

How much do remote prior authorization rn jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for remote prior authorization rn in Columbia, SC is $39.08, according to ZipRecruiter salary data. Most workers in this role earn between $29.13 and $46.25 per hour, depending on experience, location, and employer.

What is the difference between Remote Prior Authorization Rn vs Remote Medical Coder?

AspectRemote Prior Authorization RnRemote Medical Coder
CredentialsRN license, certification in case management or utilization reviewCertification in coding (CPC, CCS), high school diploma or equivalent
Work EnvironmentHealthcare facilities, insurance companies, telehealthMedical offices, insurance companies, remote coding platforms
Industry UsageUtilization review, patient authorization, insurance approvalMedical record review, billing, coding for insurance claims

Remote Prior Authorization Rns focus on reviewing patient information to approve treatments, while Remote Medical Coders translate medical records into codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare industry.

What are the most commonly searched types of Prior Authorization Rn jobs in Columbia, SC?

The most popular types of Prior Authorization Rn jobs in Columbia, SC are:

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For Remote Prior Authorization Rn jobs in Columbia, SC, the most frequently searched job titles are:

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What cities near Columbia, SC are hiring for Remote Prior Authorization Rn jobs?

Cities near Columbia, SC with the most Remote Prior Authorization Rn job openings:

Remote Prior Authorization Rn jobs near you
Infographic showing various Remote Prior Authorization Rn job openings in Columbia, SC as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $81,290 per year, or $39.1 per hour.

Quality Medical Auditor

Ourhrconnect

Columbia, SC • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

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 disabilitiesand 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.comor 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 moreinformation.

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