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Remote Chiropractic Utilization Review Jobs in Silver Spring, MD

RELI Group Inc.

Medical Review Nurse III

Baltimore, MD · On-site +1

$80K - $95K/yr

A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

RELI GROUP INC

Medical Review Nurse III

Baltimore, MD · Remote

A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

Washington, DC Experience: 5 years clinically related experience working in an acute care setting, and/or Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG

McGuireWoods LLP

Director, Benefits

Washington, DC · On-site +1

Along with excellent benefits, McGuireWoods offers most employees a hybrid remote option allowing ... Lead the annual benefits renewal process, including plan design evaluation, utilization review ...

McGuireWoods LLP

Director, Benefits

Washington, DC · On-site +1

Along with excellent benefits, McGuireWoods offers most employees a hybrid remote option allowing ... Lead the annual benefits renewal process, including plan design evaluation, utilization review ...

Centerbrite Health

BCBA (Part-time)

Fairfax, VA · On-site +1

$80 - $110/hr

... Hybrid (Remote + In-person) A rare opportunity to join a growing ABA practice as an early team ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Centerbrite Health

BCBA

Fairfax, VA · On-site +1

$90K - $110K/yr

Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ... Remote and in-clinic Job Types: Full-time

CareFirst

Clinical Appeals Nurse (Remote)

Baltimore, MD · Remote

Three (3) years Medical Review, Utilization Management, Nurse Auditor/Revenue Integrity, and/or Appeal and Grievance review at CareFirst BlueCross BlueShield, or similar Managed Care organization or ...

Koniag, Inc.

FinOps Specialist (REMOTE)

Washington, DC · On-site +1

... variances, utilization, forecast changes, material issues, and risks. * Monitor cloud budgets ... for review and disposition. * Participate in Agile or program-management ceremonies, including ...

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All JobsChiropractic Utilization Review JobsRemote Chiropractic Utilization Review JobsRemote Chiropractic Utilization Review Jobs in Silver Spring, MD

Remote Chiropractic Utilization Review information

See Silver Spring, MD salary details

$22

$43

$71

How much do remote chiropractic utilization review jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for remote chiropractic utilization review in Silver Spring, MD is $43.71, according to ZipRecruiter salary data. Most workers in this role earn between $34.52 and $50.19 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote chiropractic utilization review specialist?

To thrive as a Remote Chiropractic Utilization Review specialist, you need a Doctor of Chiropractic degree, a valid state license, and comprehensive knowledge of chiropractic procedures and medical necessity guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certification such as Certified Professional Utilization Review (CPUR) is often required. Strong analytical skills, attention to detail, and effective communication are crucial for evaluating clinical documentation and collaborating with providers. These skills ensure accurate, evidence-based reviews that support appropriate patient care and compliance with insurance standards.

What is the difference between Remote Chiropractic Utilization Review vs Remote Chiropractic Billing Specialist?

AspectRemote Chiropractic Utilization ReviewRemote Chiropractic Billing Specialist
Primary RoleAssessing medical necessity and appropriateness of chiropractic treatmentsManaging billing, coding, and insurance claims for chiropractic services
Required CredentialsChiropractic license, possibly certifications in utilization reviewMedical billing certifications, knowledge of coding and insurance policies
Work EnvironmentRemote, healthcare or insurance companiesRemote, healthcare providers or billing companies
Industry UsageUsed by insurance companies and healthcare organizations to approve treatmentsUsed by billing companies and healthcare providers for claims processing

Remote Chiropractic Utilization Review focuses on evaluating the medical necessity of chiropractic treatments, while Remote Chiropractic Billing Specialist handles billing, coding, and insurance claims. Both roles are remote and require healthcare knowledge, but they serve different functions within the chiropractic industry.

What is a remote chiropractic utilization review?

A Remote Chiropractic Utilization Review is a process where licensed chiropractors or healthcare professionals assess the necessity, efficiency, and appropriateness of chiropractic care provided to patients, but do so remotely—often from home or a centralized office. This review typically involves examining patient records, treatment plans, and billing information to ensure that care meets established clinical guidelines and insurance requirements. The goal is to improve patient outcomes, prevent unnecessary treatments, and ensure that services billed to insurance are medically necessary. Remote reviews use secure online systems and may require coordination with treating chiropractors, insurance companies, and other healthcare providers.

What are some common challenges faced in a remote chiropractic utilization review role, and how can they be managed?

One of the main challenges in a remote Chiropractic Utilization Review role is effectively evaluating clinical documentation to ensure treatment appropriateness without direct patient interaction. Communication with providers can sometimes be limited or delayed, requiring strong written and verbal skills to clarify cases efficiently. Managing time and workflow independently is crucial, as the workload may fluctuate throughout the week. Staying updated with payer guidelines and evidence-based practices is also essential for accurate reviews. Building strong virtual collaboration with team members and providers can help overcome these challenges and maintain high-quality standards.

What are popular job titles related to Remote Chiropractic Utilization Review jobs in Silver Spring, MD?

For Remote Chiropractic Utilization Review jobs in Silver Spring, MD, the most frequently searched job titles are:

What job categories do people searching Remote Chiropractic Utilization Review jobs in Silver Spring, MD look for?

The top searched job categories for Remote Chiropractic Utilization Review jobs in Silver Spring, MD are:

What cities near Silver Spring, MD are hiring for Remote Chiropractic Utilization Review jobs?

Cities near Silver Spring, MD with the most Remote Chiropractic Utilization Review job openings:

Remote Chiropractic Utilization Review jobs near you
Infographic showing various Remote Chiropractic Utilization Review job openings in Silver Spring, MD as of August 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 100% Remote job distribution, with an average salary of $90,917 per year, or $43.7 per hour.

Medical Review Nurse III

RELI Group Inc.

Baltimore, MD • On-site, Remote

$80K - $95K/yr

Full-time

Re-posted 14 days ago

Job description

About Us:
At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs.
Perform automated and complex medical record and claim reviews to make coverage determinations based on applicable Medicare coverage policies and payment rules, coding guidelines, National and Local Coverage Determinations, utilization/practice guidelines, and clinical review judgment. Provides professional assessment, planning, coordination, implementation, and reporting of complex data to support the Recovery Auditor Validation Contract (RVC).
Essential Functions
  • Perform accuracy review of automated and complex Medicare medical record and claims review in accordance with all State and Federal mandated regulations/guidelines.
  • Perform accuracy reviews as a Special Study requested by CMS.
  • Document findings for each claim in a clear and concise manner.
  • Compile a report explaining the claim reviews, including identified patterns, inappropriate determinations, as well as recommendations.
  • Reasonably determines appropriateness to consult a Subject Matter Expert (SME) for clarification.
  • Perform medical record reviews in response to RAC disputes/disagrees with the RVC review decisions.
  • Perform accuracy review of the New Issue Proposal for appropriate regulations, references, policies, and edit parameters. Compile a report of analysis and recommendations to submit to CMS.
  • Perform New Issue Quality Assurance Review for accuracy of all criteria and references.
  • Consistently meet or exceed productivity and accuracy standards of 95% minimum IRR established by the customer and/or the Company.
  • Report problems to the Medical Review Manager (MRM) and Project Manager (PM) regarding unique record or process issues.
  • Maintain security and confidentiality of medical records and Protected Health Information (PHI) and Personally Identifiable Information (PII).
  • Consistently meet attendance standards established by the Company and follows the telecommuting policy.
  • Interact appropriately with peers, co-workers, other Contractors, and the customer, when necessary. Contribute to building a positive team spirit.
  • On occasions may be asked by the MRM or PM to assist with development of training and/or resource materials.
  • May be asked to assist with precepting of new Medical Review Nurses (MRNs).
  • Perform other duties and projects as assigned.

Required Education and Experience
  • Registered Nurse, with a current unobstructed license to practice nursing in the United States. Graduate of a Board approved Registered Nursing program.
  • A Bachelor's Degree in Nursing (BSN) or other related field is preferred.
  • Certification in coding highly preferred.
  • A minimum of three (3) years clinical experience in an acute care hospital, skilled nursing facility, and/or an office/clinic-based medical practice.
  • A minimum of three (3) or more years' experience in medical/utilization medical record review particularly with Medicare and/or Medicaid.
  • Proficiency in research, interpretation, and application of Medicare, Medicaid, and local healthcare regulations and policies.
  • Must be proficient in Microsoft Office Suite such as Outlook, Excel and Word.

Skills & Abilities
  • Ability to work independently and maintain an elevated level of concentration.
  • Capable of consistency, speed, and accuracy of task.
  • Ability to read, analyze, and interpret physician documentation.
  • One year or more of utilizing InterQual and /or Milliman guidelines against inpatient services experience is preferred.
  • Ability to communicate clearly and professionally with all levels of the organization, both written and verbal.
  • Ability to work well in a remote team environment, to collaborate with others, and interface with team members internal and external to the organization.
  • Establishes and maintains effective professional relationships with internal and external stakeholders.
  • Must be able to adapt to organizational change.
  • Must be proficient in Microsoft Office Suite such as Outlook, Excel, and Word.
  • Flexibility and ability to plan, prioritize, and execute multiple tasks in a fast-paced environment.
  • Self-motivated, well-organized, and detail oriented.
  • Ability to maintain a high level of confidentiality and integrity

EEO Employer:
RELI Group is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
HUBZone:
We encourage all candidates who live in a HUBZone to apply. You can check to see if your address is located in a HUBZone by accessing the SBA HUBZone Map.
The annual salary range for this position is $80,000 to $95,000. Actual compensation will depend on a range of factors, including but not limited to the individual's skills, experience, qualifications, certifications, location, other business and organizational needs, and applicable employment laws. The estimate displayed represents the typical salary range for this position and is just one component of the total compensation package for employees. RELI Group provides a variety of additional benefits to its employees. For additional details on the benefits that RELI Group offers click here

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