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Remote RN: Medical Claims Reviewer & Compliance

Remote / Online - Candidates ideally in
Philadelphia, Philadelphia County, Pennsylvania, 19117, USA
Listing for: Socket.dev
Remote/Work from Home position
Listed on 2026-08-04
Job specializations:
  • Nursing
    RN Nurse, Healthcare Nursing
Salary/Wage Range or Industry Benchmark: 58500 - 71500 USD Yearly USD 58500.00 71500.00 YEAR
Job Description & How to Apply Below

Broadway Ventures is seeking a dedicated Registered Nurse (RN) to join our Medical Review team as a remote contributor. The role focuses on pre- and post-payment medical reviews to ensure compliance with clinical criteria and guidelines, documenting decisions per regulatory requirements.

The ideal candidate will apply clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while supporting internal and external teams through training and guidance.

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