Remote RN Medical Reviewer — Claims & Coverage

Broadway Ventures is seeking an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud and abuse referrals. This remote, full-time role requires applying clinical expertise and established guidelines to determine medical necessity and support accurate payment determinations. You will educate internal teams on medical review processes and coding requirements, contribute to quality control, and assist with special projects as #J-18808-Ljbffr Broadway Ventures LLC