This page tracks remote advocate openings that are location-eligible for Idaho.
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Hiring companies this week
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$14 - $150,000
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16 Jobs
16 Companies
Empowering Whole Person Health With Compassion and Innovation
• Managing and coordinating a high volume of service requests (phone, emails, portal, chat) from employees (and their immediate family) of our clients • Educating and assisting callers with understanding, navigating through, and obtaining value of their healthcare and wellness benefits • Providing direction in working through a variety of benefit issues
• Lead the handling of complex and high-severity claims involving Directors & Officers (D&O) Liability, Employment Practices Liability (EPL), Fiduciary Liability, Crime/Fidelity, Professional Liability / Errors & Omissions (E&O), Cyber. • Review claim notices, demand letters, subpoenas, regulatory investigations, and lawsuits to identify potential insurance coverage. • Report new matters under all applicable policies and assist clients with preservation of insurance rights. • Develop and execute claim strategies designed to maximize policyholder recovery. • Coordinate and manage communications among clients, insurers, defense counsel, coverage counsel, forensic firms, and other claim stakeholders. • Monitor insurer investigations, coverage positions, and claim handling activities to ensure timely and fair claim resolution. • Negotiate coverage disputes, defense cost advancements, settlements, and allocation issues with insurers. • Analyze policy language, endorsements, exclusions, and program structures to identify coverage opportunities and potential gaps. • Provide technical coverage analysis and guidance regarding management liability, professional liability, and cyber insurance policies. • Support policy placement teams by identifying claim trends and recommending enhancements to policy language and program structure. • Serve as a primary claims contact for assigned clients and broker teams. • Build and maintain trusted relationships with risk managers, general counsel, executives, finance leaders, and other client stakeholders. • Conduct claim reviews, stewardship meetings, and claim trend analyses for clients. • Provide proactive updates regarding claim developments, emerging exposures, and market trends. • Support new business opportunities by participating in client presentations, RFP responses, and prospect meetings.
• Provide assistance to viewers via phone and/or chat regarding account management, billing queries, content questions, and basic navigation of our site and applications. • Make Disney Streaming product recommendations on each viewer interaction. • Other duties as assigned.
• Handle provider compensation inquiries through ticket-based workflows, contributing to SLA requirements and completing upwards of 600 tickets per week. • Research, investigate, and resolve provider compensation inquiries, including missed session payments, rate questions, bonus eligibility, and payment discrepancies. • Ensure all compensation decisions align with internal policies, documented guidelines, and program integrity standards. • Identify potential trends in compensation irregularities or bonus misuse and escalate when necessary. • Evaluate provider eligibility for onboarding incentives, state-based programs, and bonus structures based on established criteria. • Communicate bonus approval or denial decisions clearly and transparently. • Maintain up-to-date knowledge of evolving incentive guidelines and assist with documentation updates as needed.
Our people are the difference. Come join us. We are certified as a Great Place To Work® for 2023!
• Receive calls from members in regards to various healthcare issues (e.g., infertility, disease, medication, etc.) and determine best course of action/s to assist the members while adhering to established policies, procedures, and key performance indicators (KPIs) • Build relationships with members in order to collaborate and develop plans of action by going above and beyond members’ initial requests • Assist and educate members in understanding their medical conditions, associated health testing, test result interpretation, and health options available to them • Provide members choices in medical care providers and services based on the members’ clinical needs, geographic locations and available benefit offerings • Research providers through credentialing, education checks and affiliations with notable medical centers within the member’s plan • Facilitate communication among members, treating physicians, and insurance carriers • Document cases in the department’s case management system using approved processes and procedures • Keep up-to-date on patient care procedures which include diagnosis, pre-certification, prior authorization, pre-service and post-service denials • Continuously stay up to date on various health issues and medical procedures necessary to offer top of the line feedback to members • Mentor new team members
As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.
• Assists clients in reporting claims to carriers, advise on managing emergency services and how to begin documenting the claim. • Consider and advise client on any other resources such as restoration firms, engineering consultants or claim preparation services. • Assist clients with managing cash flow by advocating for early advance payments and ongoing partial payments as desired by the client. • Throughout the process anticipate potential issues and communicate to the client and the adjustment team. • Provide advice and guidance on carrier coverage positions. • Advocate for client in response to any adverse coverage position. • Manage client claims to bring about timely and fair settlement by appropriate follow up activities and settlement negotiations. • Provide input to Risk Solutions placement team on client claims status as requested. • Provide feedback to the placement team on any identified coverage issues or concerns. • Develop Service Plans for claims handling based on client needs. • Support and strengthen the Practice through individual contributions and suggestions, mentoring and coaching of junior team members inside and outside the Practice, communicating of success stories to our internal team and to clients as appropriate. • Provide assistance and support for new business development/RFPs. • Develop and maintain relationships with clients, independent adjusters and vendors for the benefit of our clients. • Keep current on marketplace changes. • Attend required training sessions, courses, etc. to develop and maintain up-to-date skills and maintenance of your broker’s license. • Maintain appropriate level of confidentiality of information processed. • Follow all company policies and procedures. • Other duties as assigned.
CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
• supports customers by providing operational excellence and a deep commitment to ensuring simple and transparent experiences • responsible for delivering population health program analytics • supporting client implementations and ongoing program execution • providing support for member engagement
• Works in partnership with clinical team in support of case development and management, care and treatment plans including accurate case documentation, identifying relevant medical data to be collected and providing clear, concise communication to members, internal and external partners. • Serve as the ongoing coordinator of primary and preventative care, episodic care, expert medical opinion and other service lines • Obtains a comprehensive health history by leading members through a systematic and dynamic intake assessment • Resolves prescription issues related to episodic care within established protocols and turn-around times • Maintains availability within Outlook for scheduling of member visits and all follow ups • Utilizes the company’s proprietary database to help connect members to Teladoc Health and external physicians and completes referrals where appropriate • Conducts member health coaching and provides treatment decision support service via printed educational materials and videos • Uses clinical judgment in the review of complex medical issues to ensure accuracy of clinical summaries/reports and care plans • Provides clinical support and guidance to support staff regarding case related inquiries • Ensures adherence to established processes and compliance with privacy legislation and regulations with all parties encountered in the service delivery • Is accountable for meeting service standards for speed of case progression, overall quality, and member satisfaction • Support additional projects as needed.
We connect qualified claimants with legal representation in the most efficient and effective process for our clients.
• Build the initial claimant relationship and confidence in our firm with every prospective claimant interaction • Engage in 150 – 200 calls per day in a professional inbound/outbound call center environment • Consistently build the claimant relationship and confidence in our partners firms with every claimant interaction while proactively contacting claimants to ensure the relationship is maintained • Solve problems and maintain confidentiality • Keep updated records and detailed documentation of claimant interactions, concerns, and complaints in a paperless database system • Use good judgment to discern what issues may be urgent and need a manager’s or director’s attention immediately • Be expected to meet occupancy and adherence goals
Empowering primary care practices to deliver the highest quality care to underserved patients
• Conduct structured virtual eligibility assessments with patients and caregivers to confirm SSI/SSDI eligibility and gather the information needed to move applications forward • Request, compile, and review medical records from relevant providers, and prepare medical summary reports for submission to the Social Security Administration (SSA) and Disability Determination Services (DDS) • Submit completed applications to the SSA and DDS, and serve as the designated SSA Representative for patients without legal representation • Manage ongoing weekly outreach calls with patients to provide status updates, address questions, and keep the application process on track • Coordinate with Patient Enrollment Specialists and Health Coaches to support patients who need additional engagement or care coordination touchpoints • Handle administrative responsibilities associated with the program, including PO box management and documentation tracking, with accuracy and follow-through • Leverage AI-assisted tools to support records review and medical summary writing, with a clear understanding of when to verify outputs and how to use these tools in a HIPAA-compliant manner • Partner with internal teams to flag workflow gaps, share patient insights, and contribute to the continued development of scalable, compliant benefits enrollment processes
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