by Terrance Ellis | Feb 18, 2026 | Uncategorized
Negotiate out-of-network claim payments and help group health plans control costs without sacrificing compliance. If you’re strong in claims analysis, coding, and provider negotiation, this role is a solid remote lane with real investigative work.
About Allied Benefit Systems
Allied Benefit Systems supports employers and members through claims and benefits administration services. Their claims teams focus on accurate analysis, cost control, and compliant processing across customized health plans.
Schedule
- Full-time, fully remote
- Salary range: $48,000–$52,000
- Internet requirement: cable broadband or fiber with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Analyze healthcare claims for cost reasonableness, medical necessity, and potential fraud
- Determine benefit eligibility and appropriate payment levels based on plan terms
- Contact providers to negotiate discounts on out-of-network claims
- Reprice claims to applicable Medicare rates when appropriate
- Identify billing irregularities by reviewing procedure and diagnosis codes (CPT/ICD)
- Review and request supporting documentation (physician notes, hospital records, police reports) as needed
- Consult with external entities for additional claim evaluation when appropriate
- Process and document claims in QicLink and related systems, adding clear investigative notes
- Log negotiated claims in an Access database and prepare weekly summary reports
- Review Suspended Claim Reports and follow up on open issues
- Authorize payment, partial payment, or denial based on analysis and investigation
- Support teammates as needed and complete required continuing education (including HIPAA)
What You Need
- Bachelor’s degree or equivalent work experience
- 5+ years of medical claims analysis experience
- Strong analytical skills and attention to detail
- Knowledge of CPT and ICD coding terminology (posting mentions ICD-9)
- Comfort working across multiple systems and databases
Benefits
- Medical, dental, and vision insurance
- Life & disability insurance
- Generous paid time off (PTO)
- Tuition reimbursement
- Employee Assistance Program (EAP)
- Technology stipend
Quick gut-check: they call this “Negotiator I,” but they want 5+ years of claims analysis. That’s not entry-level. If you’ve got the experience, you’ll be competitive. If you don’t, this one will likely auto-screen you out.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 18, 2026 | Uncategorized
Keep the appeals process clean, organized, and moving. If you’re detail-driven, comfortable with medical terminology, and don’t mind document-heavy work, this is a solid remote claims support role.
About Allied Benefit Systems
Allied Benefit Systems supports employers and members through claims and benefits administration services. Their remote-friendly culture is built for accuracy, accountability, and strong coordination across internal teams, providers, and clients.
Schedule
- Full-time, fully remote
- Hourly pay: $20.00/hr
- Internet requirement: cable broadband or fiber with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Review, copy, and prep documentation to scan incoming appeals
- Sort, prepare, key, and scan appeals and related materials into DocuVantage
- Support incoming faxes by prepping and sorting documents
- Create coversheets for response packets and misc. mail needing scanning
- Prepare correspondence for clients and providers related to appeals
- Support the team with additional administrative tasks as assigned
What You Need
- High school diploma or equivalent
- 1–2 years of administrative experience
- Knowledge of medical terminology
- Experience in healthcare, claims, third-party administration, or insurance (preferred)
- Proficiency in Microsoft Word, Access, and Excel; ability to learn new systems quickly
- Ability to read, analyze, and interpret general plan benefits and guidelines
- Strong communication skills and ability to respond to questions from members, providers, clients, and coworkers
Benefits
- Medical, dental, and vision insurance
- Life & disability insurance
- Generous paid time off (PTO)
- Tuition reimbursement
- Employee Assistance Program (EAP)
- Technology stipend
If you’re the kind of person who likes tidy systems, clear workflows, and “no loose ends,” this role will feel right.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 18, 2026 | Uncategorized
Support members navigating medical conditions by keeping case work organized, documented, and moving forward. If you’re strong in healthcare admin, patient engagement, and CRM documentation, this role is a steady remote lane with real impact.
About Allied Benefit Systems
Allied Benefit Systems supports medical management services that help members access resources and navigate care. Their remote-friendly culture is built for high accountability and strong communication across internal teams, vendors, and members.
Schedule
- Full-time, fully remote
- Hourly pay: $23.00/hr
- Internet requirement: cable broadband or fiber with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Facilitate reviews, referrals, and outreach tied to referral-based strategies and Medical Management products
- Engage members to offer support and resources related to their medical condition(s) through Allied Care
- Document all member engagement clearly and accurately in Microsoft CRM
- Manage escalated and time-sensitive case management questions from members, brokers, and internal/external stakeholders
- Coordinate with strategic vendor partners to support services for members
- Lead and support claims auditing in partnership with ECM Coordinators
- Complete daily task audits to ensure accuracy and identify escalations
- Write timely closing summaries and flag impactful scenarios
- Share key scenarios with leadership for visibility across Sales, Operations, and Executive teams
- Identify and elevate escalations to department leadership as appropriate
- Handle other duties as assigned
What You Need
- Bachelor’s degree or equivalent work experience
- 3–5 years of administrative support experience
- Experience with patient-provider engagement, needs assessments, care coordination, or treatment adherence (preferred)
- Working understanding of medical terminology (CPT, HCPC, diagnostic codes)
- Understanding of benefit plan basics (deductible, out-of-pocket, prescription coverage, physical medicine services, etc.)
- Strong verbal and written communication skills
- Strong analytical and problem-solving skills
Benefits
- Medical, dental, vision, life, and disability insurance
- Generous paid time off (PTO)
- Tuition reimbursement
- Employee Assistance Program (EAP)
- Technology stipend
This is the kind of role where the difference between “good” and “great” is documentation and follow-through. If you’ve got that, you’ll stand out.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 18, 2026 | Uncategorized
Help resolve payment disputes the right way after claims have already been paid. If you’ve got healthcare claims chops and you’re comfortable negotiating with providers, this role lives at the intersection of compliance, communication, and money.
About Reliant Health Partners
Reliant Health Partners is a medical claims repricing service provider that helps employers maximize health plan savings with minimal disruption. Their solutions range from individual specialty claim repricing to full plan replacement as a high-performance network alternative.
Schedule
- Full-time, remote (United States)
What You’ll Do
- Monitor and manage post-payment claim queues
- Conduct outreach, education, and negotiation calls with providers on post-payment claims
- Explain and confirm provider understanding of No Surprises Act (NSA) payments and related regulations
- Explain claim payments across different pricing products
- Maintain strict compliance with confidentiality and HIPAA requirements
- Meet production expectations, including turnaround time standards tied to regulations
- Document all provider interactions, including contact details, rates offered, and counteroffers
- Follow client-specific and Reliant protocols, scripts, and requirements
- Build strong working knowledge of state and federal regulations impacting provider payments
- Learn and support Reliant’s product offerings
- Handle additional duties and special projects as needed
What You Need
- 2–3 years of related experience (appeals, negotiations, and/or medical billing)
- Experience doing provider outreach by phone or other communication channels
- Broad understanding of healthcare policy and payment workflows
- Experience with claims workflow tools/systems
- Strong compliance mindset and comfort working within regulated processes
- Clear communication skills and confidence negotiating payment disputes
Benefits
- $50,000–$60,000 USD salary range
- Medical, dental, vision, and life insurance coverage
- 401(k) with employer match
- Health Savings Account (HSA) and Flexible Spending Accounts (FSAs)
- Paid time off (PTO) and disability leave
- Employee Assistance Program (EAP)
They’re screening hard for people who can talk to providers without folding and still keep everything compliant. If you’ve got appeals + negotiation experience, this is a legit remote lane.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 18, 2026 | Uncategorized
Help oncology providers get cleared, privileged, and ready to serve patients without delays. If you’re organized, detail-obsessed, and comfortable juggling multiple applications and deadlines, this role is a strong remote operations lane.
About OneOncology
OneOncology supports independent community oncology practices with technology, expertise, and operational support to improve cancer care. They’re building a physician-led, data-driven model that helps practices grow while keeping care patient-centered.
Schedule
- Full-time, remote (United States)
- Travel flexibility as needed
What You’ll Do
- Manage credentialing and re-credentialing for physicians and allied health professionals
- Complete, submit, and track credentialing applications with managed care organizations (MCOs) and hospitals
- Apply for and validate hospital privileges
- Obtain malpractice insurance policies as required
- Notify internal staff when credentialing is complete for scheduling and billing readiness
- Maintain and update CAQH profiles for providers on a quarterly basis
- Manage provider databases and confidential credentialing files (digital and hard copy)
- Track and maintain clinical licenses for nursing, pharmacy, and lab personnel
- Track provider continuing education credits and notify providers of deficiencies
- Submit documentation during provider audits when requested
- Process provider terminations by removing departing providers from MCOs/hospitals/EMR within 30 days
What You Need
- High school diploma and 2+ years of related experience
- Industry experience leading credentialing in a large provider practice (or across multiple practices)
- Proficiency with MS Office (Word, Excel) and web-based applications
- Strong confidentiality practices in written and verbal communication
- High attention to detail and strong organizational skills
- Ability to prioritize and manage a heavy workload under tight deadlines in a productivity-based environment
- Strong interpersonal skills and team-oriented approach
- Research and problem-solving skills
- Bachelor’s degree preferred
- Training experience preferred (not required)
- Credentialing certifications preferred (not required)
Benefits
- Remote work with a mission-driven healthcare organization
- Exposure to multi-site provider operations and credentialing workflows
- Opportunity to improve processes in a fast-moving, growth-oriented environment
This one’s been posted for a while, which can mean they’re either still building the pipeline or being picky. Either way, a clean, credentialing-heavy resume is your best weapon here.
Happy Hunting,
~Two Chicks…
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