Medical Claims Reviewer, 6 Month Contract (Remote)
Broadway Ventures · Remote · United States - Remote
Posted by Broadway Ventures on their careers site · View the original posting
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The posting, as Broadway Ventures wrote it
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 provider—we’re your trusted partner in innovation.
Medical Review Nurse (Temporary Contract, Remote)
Compensation rate: $32.5K/$31.25/hr. 6 month salary basis
We are seeking a dedicated RN to conduct medical reviews to perform comparisons between End Stage Renal Disease patient medical records documentation and data submitted to the Centers for Medicare and Medicaid Services (CMS) End Stage Renal Disease Quality Reporting System (EQRS) and the Centers for Disease Control (CDC) National Healthcare Safety Network (NHSN) based on the approved data validation methodology. Determine and classify discrepancies found based on the type and severity of errors. Common error categories might include missing data, incorrect values, and data entered in the wrong fields.
Position Details
- Job Type: 6 Month Contract, possibility for extension/conversion
- Duration: Target; November 2026 – May 2027
- Schedule: Monday-Friday, 8:00 AM – 4:30 PM (40 hours/week)
- Location: Remote U.S. (Work from home)
- Requirements for Remote Work: High-speed internet (non-satellite) and a private, lockable home office.
Key Responsibilities
- Conduct ESRD medical record reviews comparing medical record documentation to EQRS and NHSN to determine accuracy and timely reporting.
- Determine and classify discrepancies found based on the type and severity of errors. Common error categories might include missing data, incorrect values, and data entered in the wrong fields.
- Participate in quality control activities to support corporate and team objectives.
- Assist with special projects or responsibilities as assigned by management.
Minimum Qualifications
- Licensure:
- Active, unrestricted RN licensure in the United States and in the state of hire
OR
- Active compact multistate unrestricted RN license (as defined by the Nurse Licensure Compact).
- Education:
- Associate Degree in Nursing
OR
- Graduate of an accredited School of Nursing.
- Required Experience:
- Two years of clinical experience plus two years of experience with utilization/medical review, quality assurance or end stage renal disease/dialysis.
- Skills:
- Strong clinical background in dialysis, managed care, home health, rehabilitation, and/or medical-surgical settings.
- Knowledge of specific criteria/protocol sets and the ability to use them effectively.
- Proficiency with word processing software and Microsoft Office.
- Ability to work independently, prioritize tasks, and make sound decisions.
- Excellent customer service, communic
[…]
n and work from an eligible U.S. state when they are hired and for as long as they are employed. Applications from residents of the locations listed above will not be considered.
Notice: Use of Artificial Intelligence in Our Hiring Process
Broadway Ventures uses an artificial intelligence (AI) tool to help review applications for this position.
- Who built it: Broadway Ventures developed the tool in-house.
- What it does: It compares your resume to the requirements in this job posting and gives a score from 0 to 100 showing how closely your qualifications match.
- What information it uses: The text of your resume, your name, your current or most recent job title, your location, and this job posting.
- What it cannot see: Your answers to voluntary demographic or equal employment opportunity questions, interview feedback, or offer information.
- How it is used: The score is one factor in our initial review of applications. The tool does not reject anyone. A member of our recruiting team reviews every application before any decision is made.
- Your options: If you would like your application reviewed without the AI tool, or you need a reasonable accommodation at any point in the hiring process, contact us at recruiting@broadwayventures.net. Making a request will not affect whether you are considered for this position.
Some positions are posted in support of a contract proposal that has not yet been awarded. Where that is the case, the position and its final compensation are contingent upon award of the contract to Broadway Ventures and on the terms of the awarded contract, including any government-approved labor rates and the applicable wage determination.
Broadway Ventures offers a comprehensive benefits package. A general description of benefits is below.
- 401(k) and company match
- PTO that grows the longer you stay
- Health, Vision, Dental
- Company provided Life Insurance and Voluntary Life Insurance
- Short Term Disability and Long Term Disability