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Remote Insurance Utilization Review Jobs in Springfield, VA

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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 Aug 9, 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 is a remote insurance utilization review?

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 skills and qualifications are needed for a remote insurance utilization review specialist?

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 are popular job titles related to Remote Insurance Utilization Review jobs in Springfield, VA? For Remote Insurance Utilization Review jobs in Springfield, VA, the most frequently searched job titles are:
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 August 2026, with employment types broken down into 95% Full Time, and 5% Contract. Highlights an 100% Remote job distribution, with an average salary of $91,862 per year, or $44.2 per hour.

Account Representative - State Farm Agent Team Member

Roxanne Jones - State Farm Agent

Waldorf, MD • Remote

$50K - $70K/yr

Full-time

Retirement, PTO

Re-posted 7 days ago

Job description

Benefits:
  • 401(k)
  • Bonus based on performance
  • Competitive salary
  • Opportunity for advancement
  • Paid time off
  • Training & development

Account Representative
Roxanne Jones State Farm
Remote | Full-Time
Roxanne Jones State Farm is seeking a licensed insurance professional to join our team as an Account Representative. This remote role is best suited for someone with prior State Farm agency experience who can support customers, manage sales opportunities, and contribute to agency growth with confidence.
The ideal candidate will be organized, proactive, and comfortable handling both new business conversations and existing customer account needs. This position requires strong communication skills, consistent follow-up, and the ability to work independently while maintaining high service and production standards.
Required Qualifications

• Active Property & Casualty License
• Active Life & Health License
• Minimum of 1 year of prior State Farm agency experience
• Prior insurance sales experience with demonstrated production ability
• Ability to work independently in a remote environment
• Familiarity with State Farm systems, processes, and customer expectations
Position Overview

As an Account Representative, you will work with prospective and existing customers to identify insurance needs, review coverage options, and recommend appropriate solutions. You will assist with lead follow-up, referrals, policy reviews, quoting, and account support while helping build long-term customer relationships.
This role is ideal for someone who enjoys sales, values customer service, and can manage opportunities from initial conversation through close.
Key Responsibilities

• Follow up with leads, referrals, internet inquiries, and prospecting opportunities
• Conduct needs-based conversations to identify customer needs and coverage gaps
• Quote and present auto, homeowners, renters, umbrella, life, and related insurance products
• Ask for the business and help move opportunities from quote to bind
• Assist existing customers with policy reviews, coverage questions, and account updates
• Build relationships that support retention, referrals, and agency growth
• Maintain accurate notes, documentation, and activity tracking
• Manage a consistent sales pipeline and stay accountable to production goals
• Collaborate with agency leadership and team members to support growth initiatives
What We’re Looking For

• Sales-oriented mindset with confidence discussing coverage and closing opportunities
• Strong communication and relationship-building skills
• Experience working within State Farm agency workflows
• Professional follow-up and organizational habits
• Ability to discuss multiple lines of insurance
• Self-motivated, dependable, and results-focused
• Commitment to providing a positive customer experience
Compensation & Benefits

• Competitive base salary
• Commission and performance-based incentives
• Uncapped earning potential tied to production
• Full-time remote work environment
• Ongoing coaching, training, and professional development
• Supportive agency culture focused on growth and long-term success
• Opportunity for career advancement within the agency
Equal Opportunity Employer

Roxanne Jones State Farm is an Equal Opportunity Employer. We are committed to creating an inclusive environment for all applicants and employees and do not discriminate based on race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, or veteran status. This position is with a State Farm independent contractor agent, not with State Farm Insurance Companies. We are an equal opportunity employer and value diverse perspectives.

This is a remote position.