What are the responsibilities and job description for the Medical Claims Reviewer position at Broadway Ventures?
At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service providerwe're your trusted partner in innovation.
Medical Review Nurse (Full-Time, Remote)
Join our Medical Review team! We are seeking a dedicated RN to conduct medical reviews for pre- and post-payment claims. This role involves utilizing clinical / medical information provided by physicians and providers, following established criteria / protocol sets or clinical guidelines, and documenting decisions accordingly. You'll also provide support in reviewing medical claims and utilization practices.
Position Details
- Job Type : Full-time (40 hours / week)
- Schedule : Monday-Friday, 8 : 00 AM - 4 : 30 PM
- Location : Remote U.S. (Work from home)
- Requirements for Remote Work : High-speed internet (non-satellite) and a private, lockable home office
- Salary
67,700 annually, paid bi-monthly (twice a month)
Key Responsibilities
Minimum Qualifications
Active, unrestricted RN licensure in the United States and in the state of hire
Associate Degree in Nursing
Two years of clinical experience plus two years of utilization / medical review, quality assurance, OR home health experience
Strong clinical background in managed care, home health, rehabilitation, and / or medical-surgical settings.
Preferred Qualifications
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 a recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with the most qualifies candidates.
We perform a background and drug test prior to the start of every new hires' employment. Broadway Ventures is an equal opportunity employer and VEVRAA Federal Contractor. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Salary : $67,700
