Clinical Reviewer (Utilization Review) (Remote US)
Broadway Ventures is hiring for Clinical Reviewer (Utilization Review) (Remote US) in United States. Mid level. First seen August 27, 2026; open as of November 13, 2026. Jobs taken straight from company career pages — no aggregator in between.
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- Company
- Broadway Ventures
- Where
- United States
- Level
- Mid
- First seen
- August 27, 2026
- Listed via
- Greenhouse
What the posting says
December 2026 Key Responsibilities: Conduct comprehensive reviews of home health pre-claim review (PCR) packages to determine compliance with Medicare coverage, coding, and payment criteria. Document review outcomes (affirmation/non-affirmation) with well-defined clinical rationale in the designated case management system, ensuring a turnaround time of within 7 business days. Engage with providers, as authorized, to request or clarify documentation, and escalate any provider concerns or suspected fraud in accordance with established program procedures. Maintain a standard of 98% accuracy and…
Read more and apply on Broadway Ventures' site
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