by Terrance Ellis | Feb 12, 2026 | Uncategorized
If you know how to break down a claim, spot what doesn’t add up, and confidently negotiate with providers, this role puts that skill to work every day. You’ll negotiate out-of-network payments for group health plans using cost data (reasonable and customary, Medicare pricing) and by identifying billing irregularities.
About Allied Benefit Systems
Allied Benefit Systems supports employer health plans with claims administration and related services. Their teams work to ensure claims are reviewed accurately, negotiated appropriately, and handled in compliance with privacy and security standards.
Schedule
Remote
Full time
What You’ll Do
- Negotiate out-of-network claim payments with providers and secure discounts
- Review and analyze claims for cost reasonableness, medical necessity concerns, and potential fraud indicators
- Determine benefit eligibility and payment levels based on each client’s customized plan terms
- Reprice claims to applicable Medicare rates when required
- Request and review supporting documentation (physician notes, hospital records, police reports) as needed
- Identify billing irregularities by reviewing CPT/diagnosis codes and claim details
- Analyze claims for billing inconsistencies and document findings in required systems
- Process claims and add notes within the QicLink system and other internal platforms
- Log negotiated claims in an Access database and produce weekly summary reports
- Review Suspended Claim Reports and follow up on unresolved issues
- Collaborate with internal partners and outside entities when additional evaluation is needed
- Maintain compliance with HIPAA and other applicable privacy/security requirements
- Attend required continuing education, including HIPAA training
- Support team needs and complete other duties as assigned
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-9 coding terminology
- Comfort working across multiple systems and documenting work consistently
Benefits
Allied offers a total rewards package that may include medical, dental, vision, life and disability insurance, generous paid time off, tuition reimbursement, EAP, and a technology stipend (eligibility and details provided during the hiring process).
This one is built for someone who can think like an investigator and negotiate like a professional.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 12, 2026 | Uncategorized
This is a solid “ops glue” role: you’re the person who keeps the client-facing team running clean by pushing reports, open enrollment materials, plan docs, and ID card workflows across the finish line. Not glamorous, but very useful, very steady.
About Allied Benefit Systems
Allied supports employer health plans and runs client-facing service operations. This role sits in Operations and supports the Account Management/Client Executive side.
Schedule
- Full time
- Fully remote
- Internet requirement: cable/fiber with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Communicate internal changes tied to benefit plan design, financials, and vendor partner updates
- Review/approve member ID card templates and production batches
- Create temporary ID cards for urgent access-to-care situations
- Audit plan design changes in SPDs and SBCs
- Send mid-year/renewal plan document updates to clients for signature
- Follow up on missing signatures to keep renewals compliant and on time
- Run standard claims/diagnosis/eligibility reports from the Allied website
- Build open enrollment materials (guidebooks + PowerPoints for employee meetings)
- Coordinate open enrollment logistics (giveaways, benefit fairs, etc.)
- Submit trading partner project requests to Ops for approval
- Produce/distribute basic compliance reporting when groups request it
- Help with Massachusetts Health Connector paperwork to confirm plan minimum requirements
- Submit claim adjustment projects to the Rapid Resolution Team as needed
- Download/publish vendor quarterly and monthly reports
- Support pharmacy benefit manager data extract paperwork
- Handle routine questions from Associate Client Executives
What You Need
- High school diploma or equivalent
- 2–4 years in an administrative support role
- Data entry experience
- Strong attention to detail, organization, and multitasking
- Intermediate Microsoft Office skills: Word, Excel, PowerPoint
Benefits
- Medical, dental, vision, life & disability insurance
- Generous PTO
- Tuition reimbursement
- EAP
- Technology stipend
My straight take (so you don’t waste effort):
$20/hr for 2–4 years’ experience is on the low side, but if you’re trying to pivot into healthcare benefits admin, this is a decent stepping stone because you’ll touch SPDs/SBCs, enrollments, reporting, and vendor ops. If you already have strong benefits/TPA experience, you can probably aim higher than $20.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 12, 2026 | Uncategorized
This one’s for people who don’t panic when they see 837/835 files. You’re basically the “claims traffic controller” making sure data is clean, errors get fixed fast, and Anthem/Blue Shield aren’t sitting on inventory because something broke upstream.
About Allied Benefit Systems
Allied supports healthcare benefits administration and claims operations. This role sits in Operations and works closely with internal EDI/Claims teams plus major health plan partners.
Schedule
- Full time
- Fully remote
- Internet requirement: cable/fiber with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Analyze and validate 837 (institutional/professional) and 835 (remittance advice) files
- Spot discrepancies, formatting issues, and data integrity problems
- Partner with EDI, Claims, and other internal teams to resolve file errors and escalations
- Process file adjustments and resolve issues using vendor portals/tools
- Monitor daily operational reports: claims processing, payment reconciliation, error tracking
- Monitor inventory reports from health plan partners to meet turnaround timeframes
- Identify trends/insights to improve performance and support compliance
- Act as primary point of contact between Claims Ops and health plans (Anthem, Blue Shield)
- Run regular status meetings, escalate issues, and track action items
- Recommend workflow/reporting enhancements
- Support implementations that impact claims data exchange
What You Need
- Bachelor’s degree in a related field or equivalent work experience
- 3+ years in healthcare claims processing/claims analysis, ideally with 837/835 exposure
- Strong understanding of HIPAA transaction standards and EDI formats
- Experience with TPAs and major health plans (Anthem/Blue Shield preferred)
- Strong Excel skills (data visualization tools are a plus)
- Organized, detail-obsessed, able to juggle multiple priorities
- Familiarity with claims adjudication systems
Benefits
- Medical, dental, vision, life & disability insurance
- Generous PTO
- Tuition reimbursement
- EAP
- Technology stipend
Quick gut-check (because I’m not gonna let you waste time):
If you can confidently speak to how an 837 becomes a paid claim + how the 835 explains the payment, and you’ve actually investigated file errors (not just “worked claims”), this is a strong match. If you’ve never touched EDI files and only worked denial follow-up, this might be a stretch.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 12, 2026 | Uncategorized
If you’re the type who can keep contracts, renewals, and systems clean without letting details slip, this role is basically “make sure the paperwork doesn’t sink the ship.” You’ll support Implementation leadership and keep client contract data accurate across tools and vendors.
About Allied Benefit Systems
Allied supports employers and members through benefit administration and healthcare operations, partnering with internal teams and external vendors to deliver benefits services smoothly.
Schedule
- Full time
- Fully remote
- Internet requirement: cable broadband or fiber with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Support the Senior Director, Implementation by maintaining and updating client contracts
- Partner with Sales and Account Management to collect contract documentation for new business and renewals
- Work with Legal on template contract updates
- Track and report new business tasks
- Perform paperwork and billing audits
- Update BenefitPoint and other databases; keep contract terms current in CRM
- Handle website administration functions
- Communicate new clients to vendors (PPO, UR, etc.)
- Create renewal and new business contracts with Sales/Marketing
- Send contracts, track receipt, and manage contract routing
- Administer systems including BenefitPoint and Docuvantage
- Support Account Management implementation tasks
- Coordinate vendor contracts
- Maintain strong communication with internal/external stakeholders
- Other duties as assigned
What You Need
- Bachelor’s degree or equivalent work experience (required)
- 3–5 years contracts administration experience (required)
- Demonstrated knowledge of healthcare industry legal/regulatory requirements
- Intermediate Microsoft Office skills
- Strong analytical and organizational skills
Benefits
- Medical, dental, vision, life & disability insurance
- Generous paid time off
- Tuition reimbursement
- EAP
- Technology stipend
$48K–$50K is tight for “contracts + healthcare regulatory + multi-system admin,” but if you already have BenefitPoint/Docuvantage experience, it can be a strong resume-builder that translates into higher-paying contract ops roles later.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Feb 12, 2026 | Uncategorized
Support members dealing with ongoing medical conditions by coordinating outreach, documenting engagement, and keeping case management operations accurate and audit-ready. If you’re organized, calm with escalations, and comfortable inside healthcare terminology, this one fits.
About Allied Benefit Systems
Allied supports members through medical management programs like Allied Care, partnering with internal teams and vendors to deliver resources, coordination, and member support.
Schedule
- Fully remote
- Full time
- 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 proprietary referral-based strategies
- Engage members across Medical Management products to offer support and resources
- Document engagement accurately in Microsoft CRM
- Manage escalated and time-sensitive case management questions from members, brokers, and internal/external stakeholders
- Collaborate with vendor partners to provide supportive services to members
- Lead and support claims auditing alongside ECM Coordinators
- Complete daily department auditing to ensure accuracy and flag escalations
- Write timely closing summaries and identify impactful scenarios
- Share key scenarios with leadership for visibility across Sales, Ops, and Executive teams
- Identify and route escalations to leadership as needed
- Other duties as assigned
What You Need
- Bachelor’s degree or equivalent work experience (required)
- 3–5 years administrative support experience (required)
- Healthcare/social services experience preferred (patient engagement, needs assessments, care coordination, adherence support)
- Familiarity with medical terminology and codes (CPT, HCPCS, diagnosis codes)
- Understanding of benefit plan terms (deductible, out-of-pocket, Rx, physical medicine services, etc.)
- Strong verbal/written communication
- Strong analytical and problem-solving skills
Benefits
- Medical, dental, vision, life & disability insurance
- Generous paid time off
- Tuition reimbursement
- Employee Assistance Program (EAP)
- Technology stipend
$23/hour is solid for remote admin-heavy case coordination, but it’s also “one rate, one lane” (posted as $23.00–$23.00). So the win here is stability, benefits, and transferable healthcare ops experience.
Happy Hunting,
~Two Chicks…
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