2

Remote Insurance Utilization Review Jobs in Virginia

Review emails and Microsoft Teams messages at the start of each shift * Log into internal systems ... In addition, Conduent provides a variety of benefits to employees including health insurance ...

Review emails and Microsoft Teams messages at the start of each shift * Log into internal systems ... In addition, Conduent provides a variety of benefits to employees including health insurance ...

next page

Showing results 1-20

Remote Insurance Utilization Review information

What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?

AspectRemote Insurance Utilization ReviewRemote Claims Reviewer
CredentialsTypically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professionalUsually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H
Work EnvironmentRemote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of servicesRemote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance
Industry UsageCommonly used in healthcare insurance to evaluate medical necessityUsed across insurance sectors to process and validate claims

Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.

How does a remote insurance utilization review professional collaborate with healthcare providers and insurance companies?

Remote insurance utilization review professionals regularly interact with healthcare providers to gather patient information, clarify treatment plans, and ensure that clinical documentation supports insurance requirements. They also communicate with insurance companies to advocate for patient care, provide necessary justifications, and resolve coverage issues. While the work is done remotely, collaboration typically occurs via secure email, phone calls, and virtual meetings, requiring strong communication and organizational skills to ensure timely and accurate exchange of information.

What are remote insurance utilization review jobs?

Remote insurance utilization review jobs involve evaluating medical records and treatment plans to determine whether healthcare services are medically necessary and covered by a patient’s insurance plan. Professionals in these roles, often nurses or other healthcare specialists, work from home and communicate with healthcare providers, insurance companies, and patients. Their main goal is to ensure that patients receive appropriate care while also helping insurance companies manage costs and comply with regulations.

What are the key skills and qualifications needed to thrive as a Remote Insurance Utilization Review Specialist, and why are they important?

To thrive as a Remote Insurance Utilization Review Specialist, you need a strong understanding of medical terminology, clinical guidelines, and insurance policies—usually supported by a nursing or health-related degree and relevant licensure. Familiarity with electronic medical record (EMR) systems, insurance claims platforms, and utilization review software is essential. Strong analytical skills, attention to detail, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulations, and clear communication between healthcare providers and insurers.
What job categories do people searching Remote Insurance Utilization Review jobs in Virginia look for? The top searched job categories for Remote Insurance Utilization Review jobs in Virginia are:
What cities in Virginia are hiring for Remote Insurance Utilization Review jobs? Cities in Virginia with the most Remote Insurance Utilization Review job openings:

Commercial Lines Account Manager (NC hybrid/remote)

NFP

Reston, VA • On-site, Remote

Full-time

Medical, Retirement, PTO

Posted 12 days ago


Job description

Who We Are: 

NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance who has also earned the WORK180 employer endorsement. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: https://www.NFP.com.

Job Summary:

This is a full-time, exempt, support position assisting the Account Team in the management of the existing BOB with emphasis in full retention responsibility. The primary function of this position is to provide quality service to clients and cross-sell/account-round within the existing book of business.  The Account Manager (AM) will be the day-to-day liaison between the insurance company and designated middle-market accounts.  You will manage and control relationships with clients in collaboration with Producers and/or Account Executives. Daily servicing of clients will include contract analysis, coverage and exposure analysis, endorsement activity, routine coverage and billing questions, problem-solving, renewal control, preparation of quotes/proposals, binding coverage, and claim reporting and follow-up.  You will assist Producer(s) with the above functions as needed. You should have P&C experience and an active P&C license. Have knowledge and experience in select commercial insurance including, but not limited to, commercial auto, property, general liability, umbrella, inland marine, workers compensation, and flood.  

This is a full-time position, ideally working hybrid from either our Charlotte, NC office. We will consider a remote option for well-experienced Commercial Lines candidates able to work on an EST schedule. When working from home, you must maintain a private workspace to secure company equipment and correspondence; maintain high-speed internet, be present and responsive online and minimize personal interruptions during your work shift

Job Goals:

  • Give the most prompt, accurate, and courteous service that customers have ever received…anywhere.
  • Increase revenue by rounding out commercial lines accounts. Negotiate pricing and coverage terms in the client’s best interest.
  • Develop relationships that lead to new business sales.

Essential Core Duties and Responsibilities

  • Build and maintain constructive and effective relationships with clients by meeting and exceeding expectations.
  • Provide consistent, accurate, timely, and pertinent communication to clients.
  • Resolve/assist with any service issues/questions.
  • Assist clients in making appropriate coverage changes, making each contact a marketing opportunity.
  • Inform and educate clients about coverage, exclusions and exposures and document electronic files accordingly.
  • Respond to clients’ needs by providing/producing binders, certificates, policies, auto id cards, evidence of insurance, and other related items accurately and on time.
  • Monitor and review client satisfaction.
  • Electronically document all communication with clients.
  • As appropriate, market, negotiate, prepare and analyze alternative renewal options.
  • Develop written, graphic, and electronic renewal materials as appropriate.
  • Follow established agency procedures for effective utilization of agency management system.
  • Take advantage of personal and professional development opportunities such as continuing education, professional designations, and in-house training.
  • Adhere to all state laws and regulations regarding insurance agents (licensing, continuing education, etc).
  • Assist with or complete other tasks as directed by agency management.

Job Specifications/Requirements:

  • Property and casualty insurance license upon hire is required.
  • At least 2 years of experience in commercial lines insurance, with an understanding of underwriting, coverage and rate analysis.
  • In-depth knowledge of insurance coverages and an ability to communicate this knowledge clearly to clients and underwriters.
  • Strong written and verbal communication skills.
  • Ability to prioritize and self-manage workload.
  • Proficiency in Microsoft Word and Excel.
  • EPIC experience is preferred, but will consider other agency management system experience.
  • If not experienced with EPIC and seeking a remote role, on-site training may be required in one of our select East Coast offices.
  • When working from home, you must maintain a private workspace to secure company equipment and correspondence; maintain high-speed internet, be present and responsive online and minimize personal interruptions during your work shift.

What We Offer:

We're proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others. The base salary range for this position is $60,000 – $95,000. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.

NFP and You... Better Together!

NFP is an inclusive Equal Employment Opportunity employer.