Medical Reviewer II

Health Care Service Corporation

Medical Reviewer II at HCSC responsible for performing medical review of claims and responding to correspondence. Requires RN license and clinical experience.

Posted 7/11/2026full-timeRemote • Illinois, Montana, New Mexico, Oklahoma, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $61,500 - $136,100 per yearWebsite

About the role

Key responsibilities & impact

Perform accurate and timely medical review of claims suspended for medical necessity
Initiate and/or respond to correspondence from providers or members concerning medical determinations

Requirements

What you’ll need

Registered Nurse with current, active RN license
3 years clinical experience
Verbal and written communications skills
Analytical and decision-making skills
Customer Service skills

Benefits

Comp & perks

Health and wellness benefits
401(k) savings plan
Pension plan
Paid time off
Paid parental leave
Disability insurance
Supplemental life insurance
Employee assistance program
Paid holidays
Tuition reimbursement
Other incentives

ATS Keywords

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Applicant Tracking System Keywords

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Soft Skills

Verbal CommunicationWritten CommunicationDecision-Making

Certifications

Active RN License