Medical Claims Reviewer, 6 Month Contract (Remote)

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.

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, communication, organizational, and critical thinking skills.
• Ability to handle confidential information with discretion.
• Proficient with computers, including the ability to use multiple screens and programs simultaneously.

Preferred Qualifications

• Three years of clinical nursing experience in End Stage Renal Disease/Dialysis (strongly preferred).

What to Expect Next:

After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.

Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law.

Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).

The pay range shown is a good-faith estimate of the compensation Broadway Ventures reasonably expects to pay for this position at the time of posting. It is not a guarantee of any particular wage, salary, or total compensation. Actual pay offered depends on job-related factors, which may include skills, experience, education, certifications and licensure, geographic work location, contract funding and budget. For positions covered by the Service Contract Act, pay is also governed by the applicable Department of Labor wage determination, which the government may revise.

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