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← Broadway Ventures

Remote Medical Reviewer (Medicare- Home Health)

Broadway Ventures
Location
United States
Posted
1 month ago
Department
Medical Services
Salary
$62-$65K
What they actually want (must-haves)
  • Active, unrestricted RN license in the United States or active compact multistate RN license
  • Associate Degree in Nursing or graduate of an accredited School of Nursing
  • Two years of clinical experience and at least two years in inpatient or outpatient settings, utilization or medical review, or quality assurance
  • Strong clinical background in managed care and/or inpatient and outpatient settings
  • Ability to interpret and apply medical review criteria and clinical guidelines
  • Proficiency in Microsoft Office and word processing software
What the job really is

As a Remote Medical Reviewer at Broadway Ventures, you will leverage your clinical expertise to review complex medical claims, pre-authorization requests, and appeals. Your role involves assessing medical necessity and ensuring accurate payment determinations while educating teams on medical review processes. You will also support quality control activities and assist with special projects as needed.

Benefits
  • 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
Things to weigh
  • No specific mention of remote work challenges or team dynamics
  • Pay range is stated but actual compensation may vary based on multiple factors
  • Some positions may be contingent on contract awards, affecting job security
Job score4/5
Benefits3/5
Freshness4/5
Career value4/5
Role clarity4/5
Pay transparency5/5

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