Broadway Ventures

Remote Medical Claims Processor I (Temporary role)

Broadway Ventures · Part Time · 6 days ago

Broadway Ventures

🌎 United States 💵 $20 - $23 per hour ⭐ 5-10 yrs exp 💼 Data Entry

Analyze and process complex medical claims in accordance with program policies and HIPAA regulations. Collaborate with internal departments to resolve discrepancies and monitor claim trends for process improvement.

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Medical Claim Reviewer (CGS, DMEC)

Broadway Ventures · Full Time · a month ago

Broadway Ventures

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Conduct pre- and post-payment medical reviews to ensure compliance with clinical criteria and guidelines. Assess medical necessity and reimbursement eligibility for complex claims, appeals, and fraud referrals.

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Remote RN – Medical Claims Reviewer

Broadway Ventures · Full Time · a month ago

Broadway Ventures

🌎 United States ⭐ 2-5 yrs exp 💼 Legal

Conduct pre- and post-payment medical reviews to ensure compliance with clinical criteria and reimbursement eligibility. Document rationales for service approvals or denials and provide guidance to LPN and non-clinical staff.

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Reimbursement Specialist

Broadway Ventures · Full Time · a month ago

Broadway Ventures

🌎 United States ⭐ 2-5 yrs exp 💼 Others

Manage the accuracy and timeliness of Medicare cost report acceptance and settlements within the Fiscal Intermediary Shared Systems (FISS). Collaborate with internal departments and providers to resolve reimbursement issues and ensure proper healthcare funding.

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Directory Review Analyst

Broadway Ventures · Full Time · a month ago

Broadway Ventures

🌎 United States 💵 $60000 - $75000 per year ⭐ 2-5 yrs exp 💼 Others

Perform entry-by-entry compliance reviews of TEFCA directory records using documented protocols and authoritative reference sources. Document findings and dispositions in Jira while maintaining a complete audit trail for federal health IT program reporting.

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Hematology/Oncology, Physician Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures · Full Time · 2 months ago

Broadway Ventures

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Conduct objective medical case audits and quality reviews for the Department of Veterans Affairs to assess care appropriateness. Provide expert medical advisory opinions and identify opportunities for performance improvement based on clinical best practices.

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Remote Home Health RN – Medical Claims Reviewer

Broadway Ventures · Full Time · 2 months ago

Broadway Ventures

🌎 United States 💵 $60000 - $63000 per year ⭐ 2-5 yrs exp 💼 Legal

The role involves conducting pre- and post-payment medical reviews to ensure compliance with clinical criteria and guidelines. Responsibilities include reviewing claims, assessing payment determinations, and providing guidance to team members.

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Gastroenterology Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures · Full Time · 2 months ago

Broadway Ventures

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Conduct independent medical case reviews for the Department of Veterans Affairs to assess quality of care and adherence to standards. Provide expert medical advisory opinions and identify opportunities for performance improvement.

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Nephrology Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures · Full Time · 2 months ago

Broadway Ventures

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Conduct independent medical case reviews and audits for the Department of Veterans Affairs to assess quality of care and adherence to standards. Provide expert medical advisory opinions and identify opportunities for performance improvement.

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Surgical Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures · Full Time · 2 months ago

Broadway Ventures

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Conduct independent medical case reviews and audits for the Department of Veterans Affairs to assess quality of care and adherence to standards. Provide expert medical advisory opinions and identify opportunities for performance improvement.

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Radiology Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures · Full Time · 2 months ago

Broadway Ventures

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Conduct independent medical case reviews and audits for the Department of Veterans Affairs to assess quality of care and adherence to standards. Provide expert medical advisory opinions and identify opportunities for performance improvement.

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Cardiology Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures · Full Time · 2 months ago

Broadway Ventures

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Conduct independent medical case reviews and audits for the Department of Veterans Affairs to assess quality of care and adherence to standards. Provide expert medical advisory opinions and identify opportunities for performance improvement based on evidence-based perspectives.

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Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures · Full Time · 6 months ago

Broadway Ventures

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

The physician will conduct independent medical case reviews to assess quality of care and adherence to standards. They will also provide expert medical opinions and identify opportunities for improvement.

recruiting medical communication hiring testing compliance

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