Medical Claims Reviewer - Remote

Broadway Ventures
Nashville, TN
Job Description
Broadway Ventures is seeking an experienced Registered Nurse to conduct pre- and post-payment medical reviews for Durable Medical Equipment (DME) claims. This role involves assessing claims for medical necessity, ensuring compliance with Medicare guidelines, and providing support to internal teams. The company is a 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business.

Requirements

  • Active, unrestricted RN license in the U.S.
  • Associate’s degree in a related field OR graduate of an Accredited School of Nursing.
  • Minimum two years of clinical nursing experience.
  • Strong analytical, critical thinking, and organizational skills.
  • Proficiency in Microsoft Office and ability to work with multiple software programs.
  • Confidentiality ability to handle sensitive information.

Benefits

  • Dental insurance
  • Medical insurance
  • Life & Disability insurance
  • Paid Time Off
  • Paid Holidays
  • 401(k) with company match
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