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Remote Insurance Utilization Review Jobs in Springfield, VA

Centerbrite

BCBA (Part-time) (Remote)

Fairfax, VA · Remote

$80 - $110/hr

BCBA (Board Certified Behavior Analyst) - Part-time $80110/hr Flexible Schedule Hybrid (Remote + In ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Apply Early

Pharmacy Careers

Appeals Pharmacist (Remote)

Ashburn, VA · On-site +1

$58.50 - $71.25/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Annandale, VA · On-site +1

$57 - $69.50/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Silver Spring, MD · On-site +1

$59 - $72/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

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All JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Springfield, VA

Remote Insurance Utilization Review information

See Springfield, VA salary details

$22

$44

$72

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

As of Jun 30, 2026, the average hourly pay for remote insurance utilization review in Springfield, VA is $44.16, according to ZipRecruiter salary data. Most workers in this role earn between $34.90 and $50.72 per hour, depending on experience, location, and employer.

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 Springfield, VA look for? The top searched job categories for Remote Insurance Utilization Review jobs in Springfield, VA are:
What cities near Springfield, VA are hiring for Remote Insurance Utilization Review jobs? Cities near Springfield, VA with the most Remote Insurance Utilization Review job openings:
Remote Insurance Utilization Review jobs near you
Infographic showing various Remote Insurance Utilization Review job openings in Springfield, VA as of June 2026, with employment types broken down into 67% Full Time, 24% Part Time, 3% Temporary, 3% Contract, and 3% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $91,862 per year, or $44.2 per hour.

Remote Licensed Insurance Sales Rep

Forbes Insurance

Reston, VA • Remote

$55K - $75K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 14 days ago

Job description

Forbes Insurance Agency, Inc. is a Reston, Virginiabased property and casualty agency established in 1999. We specialize in home, auto, umbrella, and small-business coverage, with a strong emphasis on proactive renewal reviews and cross-selling. Our growth model is relationship-based and retention-focused, not transactional. Our agency culture is ethical and focused on building stable relationships rather than chasing quick wins. Employees consistently highlight our unmatched leadership support, positive atmosphere, flexibility, and goal-oriented culture as reasons they love working here.

We are seeking an experienced Remote Insurance Sales Representative who thrives in a self structured enviroment. This role is designed for professionals who value clarity, measurable expectations, and long-term book development.

  • Base salary of $36,000
  • Paid time off, paid sick leave, and paid holidays
  • Health, dental, and vision insurance
  • 401k and retirement plan
  • Monday through Friday schedule

If you want structure, accountability, and the opportunity to build a meaningful career, apply today!


Benefits

Annual Base Salary + Commission + Bonus Opportunities

Paid Time Off (PTO)

Work from Home

Health Insurance

Dental Insurance

Vision Insurance

Hands on Training

Mon-Fri Schedule

Retirement Plan

Evenings off

Weekends off

Bonus Opportunities

Warm Leads Provided

Work-Life Balance

Holidays Off

Paid Holidays

401k Plan

Professional Development

Continuing Education Opportunities

Ongoing Training Seminars

Performance Bonuses

Professional Work Environment

Team Building Activities

Equipment Provided

Paid Sick Leave


Responsibilities
  • Provide professional, timely service to existing clients
  • Process billing inquiries, coverage changes, and renewals
  • Conduct proactive needs-based insurance reviews
  • Identify cross-selling and outbound new business opportunities
  • Maintain accurate documentation and underwriting compliance
  • Manage activity pipeline and support agency growth goals

Requirements
  • Active Property & Casualty license is required
  • 2 years of prior insurance sales experience
  • 1 year of prior remote work experience
  • Strong communication, organization, and multitasking skills
  • Goal-oriented and self-motivated
  • Proficient in Microsoft Office and agency management systems
  • Spanish fluency is a plus