ZipRecruiter

Log In

2

Utilization Review Coordinator Remote Jobs in Washington

Harris

Remote Care Management - CMA

Washington, DC · Remote

Remote Join our mission to help transform healthcare delivery from reactive, episodic care to ... Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ...

IMEG

Virtual Design Coordinator | Remote

Germantown, MD · On-site +1

$71K - $98K/yr

IMEG is hiring a Virtual Design Coordinator in Germantown, Maryland or remote, to oversee and ... Review the effectiveness of current standards and procedures and validate compliance * Lead and ...

IMEG

Virtual Design Coordinator | Remote

Germantown, MD · On-site +1

$71K - $98K/yr

IMEG is hiring a Virtual Design Coordinator in Germantown, Maryland or remote, to oversee and ... Review the effectiveness of current standards and procedures and validate compliance * Lead and ...

i2G Systems

Remote Engineering Coordinator

Sterling, VA · Remote

The remote Engineering Coordinator serves as a vital bridge between high-level executive operations ... Review requests for completeness and required documentation. * Coordinate task assignments and ...

New

next page

Showing results 1-20

All JobsUtilization Review JobsUtilization Review Coordinator Remote JobsUtilization Review Coordinator Remote Jobs in Washington

Utilization Review Coordinator Remote information

What does a utilization review coordinator do when working remotely?

A Utilization Review Coordinator working remotely is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and procedures. They review medical records, treatment plans, and insurance policies to ensure compliance with regulations and that patients receive proper care without unnecessary costs. Remote UR Coordinators collaborate with healthcare providers, payers, and patients primarily through electronic records and virtual communication, maintaining strong organizational and analytical skills. Their goal is to optimize patient outcomes while managing healthcare resources effectively.

How does a utilization review coordinator typically collaborate with healthcare providers and insurance companies?

As a remote Utilization Review Coordinator, you will regularly communicate with healthcare providers and insurance representatives via phone, email, and secure digital platforms. Your main responsibilities include reviewing patient records, making coverage determinations, and ensuring compliance with regulatory guidelines. Collaboration often involves clarifying medical necessity, gathering additional documentation, and participating in virtual team meetings to discuss complex cases. Strong communication skills and comfort with digital tools are essential for seamless coordination across remote teams.

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

To thrive as a Utilization Review Coordinator Remote, you need a strong background in healthcare, knowledge of medical terminology, and often an active RN or LPN license. Familiarity with utilization management software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is typically required. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for evaluating medical necessity and collaborating with providers. These skills ensure accurate, efficient case reviews and compliance with regulations, which are vital for optimizing patient care and managing healthcare costs.

What are popular job titles related to Utilization Review Coordinator Remote jobs in Washington?

For Utilization Review Coordinator Remote jobs in Washington, the most frequently searched job titles are:

What job categories do people searching Utilization Review Coordinator Remote jobs in Washington look for?

The top searched job categories for Utilization Review Coordinator Remote jobs in Washington are:

What cities in Washington are hiring for Utilization Review Coordinator Remote jobs?

Cities in Washington with the most Utilization Review Coordinator Remote job openings:

Utilization Review Coordinator Remote jobs near you
Infographic showing various Utilization Review Coordinator Remote job openings in Washington as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 4% Contract, and 1% Nights. Highlights an 86% Physical, 3% Hybrid, and 11% Remote job distribution.

RN Reviewer/ Workers' Compensation Utilization Review - REMOTE

MICHIGAN PEER REVIEW ORGANIZATION

Washington, DC • Remote

Contractor

Posted 2 days ago

New

Job description

iMPROve Health is seeking an RN Reviewer (Workers' Compensation Utilization Review) to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis.  As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type.

BENEFITS:

  • Make a Difference: Use your clinical knowledge to improve the quality of care patients receive.
  • Professional Recognition: Join a network of highly respected experts in your specialty.
  • Competitive Compensation: Receive fair pay for your time and expertise.
  • Protect Standards of Care: Help uphold the integrity of your profession.
  • Work Remotely: Review cases from the convenience of your home or office.
Qualifications

  • Active, unrestricted RN license required; New York RN license strongly preferred.
  • Minimum three (3) years of experience in workers' compensation, utilization review, case management, or occupational health.
  • Working knowledge of Workers' Compensation Medical Treatment Guidelines and evidence-based clinical criteria.
  • Strong clinical assessment, critical thinking, and written communication skills.
  • Experience reviewing medical records and determining medical necessity preferred.

Responsibilities

  • Review treatment requests and medical records for medical necessity and guideline compliance.
  • Apply Workers' Compensation Medical Treatment Guidelines and applicable regulatory requirements.
  • Prepare clear, objective, and timely review determinations.
  • Maintain confidentiality and comply with HIPAA and other applicable privacy requirements.

Technical Requirements

  • Reliable high-speed internet/Wi-Fi connection.
  • Secure home office environment with the ability to protect confidential information.
  • Proficiency using web-based review platforms and Microsoft Office applications.

OTHER REQUIREMENTS:

  • Must complete the electronic credentialing application and receive organizational approval prior to performing a case review.
  • Must complete a conflict of interest attestation upon credentialing and prior to performing a case review.
  • Active hospital medical staff privileges may be required, as applicable.
  • Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status.

EOE/VET/Disability