Remote RN – Medical Claims Reviewer

About the Role

Broadway Ventures seeks a full-time Registered Nurse to join their Medical Claims Review team remotely. This role involves reviewing medical claims for compliance and appropriateness using clinical expertise.

Key Responsibilities

• Review complex medical claims, pre-authorizations, appeals, and fraud referrals.
• Assess medical necessity and reimbursement eligibility.
• Provide clear documentation and educate teams on review processes.
• Support quality control and special projects.

Requirements

• Active, unrestricted RN license in the U. S. or compact multistate license.
• Associate Degree in Nursing or accredited nursing school graduate.
• Minimum two years clinical experience plus two years in home health utilization, medical review, or quality assurance.
• Strong clinical background and decision-making skills.

Benefits & Compensation

• Salary: $65,000 annually ($31.25/hour).
• Full medical, dental, and vision insurance.
• 401k retirement plan.
• Equipment provided for remote work.

Work Schedule

• Full-time, Monday through Friday, 8:00 AM to 5:00 PM.
• No call or weekend requirements explicitly stated.

This remote RN role offers a stable schedule with full benefits and no call. Ideal for experienced nurses seeking work-from-home opportunities with predictable hours and comprehensive support.