RN Senior Medical Reviewer

<div class="content-intro"><div class="et_pb_module et_pb_text et_pb_text_0 et_pb_text_align_left et_pb_bg_layout_light"><div class="et_pb_text_inner">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.</div></div></div><h2 data-start="7172" data-end="7201">RN Senior Medical Reviewer</h2>Position Summary The RN Senior Medical Reviewer provides advanced medical review expertise and supports oversight of the medical review process, focusing on complex services and quality assurance.Education<ul data-start="7421" data-end="7459"><li data-start="7421" data-end="7459">Bachelor of Science in Nursing (BSN)</li></ul>Licensure / Certifications<ul data-start="7492" data-end="7608"><li data-start="7492" data-end="7569">Current, active, unencumbered Registered Nurse license in the United States</li><li data-start="7570" data-end="7608">Certified Coder credentials required</li></ul>Experience<ul data-start="7625" data-end="7820"><li data-start="7625" data-end="7689">Minimum of three (3) years of medical record review experience</li><li data-start="7690" data-end="7763">At least three (3) years of current and/or relevant clinical experience</li><li data-start="7764" data-end="7820">Two (2) years of quality assurance experience required</li></ul>Additional Qualifications<ul data-start="7852" data-end="7968"><li data-start="7852" data-end="7897">Extensive knowledge of the Medicare program</li><li data-start="7898" data-end="7968">Working knowledge of CMS FFS RAC Program requirements and activities</li></ul>Key Responsibilities<ul data-start="7995" data-end="8336"><li data-start="7995" data-end="8072">Assist Medical Review Management with monitoring the medical review process</li><li data-start="8073" data-end="8126">Conduct medical record reviews for complex services</li><li data-start="8127" data-end="8198">Evaluate compliance with Medicare coverage, coding, and billing rules</li><li data-start="8199" data-end="8255">Contribute to medical review and proposal deliverables</li><li data-start="8256" data-end="8336">Participate in quality assurance activities to ensure consistency and accuracy</li></ul><div class="content-conclusion">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).</div>

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