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Medical Claims Reviewer, 6 Month Contract

United States - 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.

Medical Review Nurse (Temporary Contract, Remote)

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: Contract (40 hours/week)
  • Duration: November 3rd – May 3rd
  • 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.

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 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 discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting.

Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

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