by Terrance Ellis | Nov 27, 2025 | Uncategorized
If you like numbers, tracking details, and making sure money lands where it should, this role is your sweet spot. As a Stop Loss Data Specialist, you’ll help keep large medical claims and reimbursements in check so clients and members aren’t left hanging.
About Allied Benefit Systems
Allied Benefit Systems is a national healthcare benefits administrator partnering with employers to design and manage flexible, self-funded health plans. The company focuses on smarter plan design, cost control, and strong service for both clients and members. As part of the Operations team, you’ll support the behind-the-scenes financial and claims processes that keep everything running smoothly.
Schedule
- Full-time, fully remote position
- Standard business hours (specific schedule may vary by team)
- Remote-friendly culture designed to support productivity and balance
- Must have reliable cable or fiber internet with minimum speeds of 100 Mbps download / 25 Mbps upload
What You’ll Do
- Perform monthly audits to confirm all stop loss claims have been filed and reimbursements received
- Update and maintain stop loss tracking tools and specific logs to monitor members over specific deductibles
- Review and accurately record stop loss reimbursements in internal systems
- Gather and prepare data needed to file Rx stop loss claims
- Request and track Actively at Work forms from clients
- Manage the cash advance process, including selecting claims for cash advances and mailing checks when reimbursements arrive
- Support the Stop Loss Claim Specialists with administrative, organizational, and auditing tasks
- Handle other related duties as assigned to support the stop loss and operations teams
What You Need
- High school diploma or equivalent; some college or equivalent work experience preferred
- 1–2 years of experience in an office environment
- Strong organizational skills and sharp attention to detail
- Strong analytical and problem-solving skills
- Excellent verbal and written communication skills
- Proven time management skills with the ability to meet deadlines
- Comfort functioning in a high-paced, sometimes stressful environment
- Proficiency with Microsoft Office Suite or related software
- Medical claims experience preferred; accounting, finance, TPA, or insurance experience a plus
Benefits
- Competitive hourly pay range of $23.00–$24.00, depending on experience and qualifications
- Comprehensive Total Rewards package
- Medical, Dental, and Vision insurance
- Life and Disability insurance
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support your remote work setup
If you’re ready to put your data skills to work in a fully remote, detail-driven role with real impact on claim dollars, this is a solid next move.
Don’t wait on it—roles like this go fast when the right candidates see them.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 27, 2025 | Uncategorized
Help members get fair outcomes on their medical claims without ever stepping into an office. In this role, you’ll own the appeals process behind the scenes, making sure claims are reviewed accurately, documented clearly, and moved toward resolution.
About Allied Benefit Systems
Allied Benefit Systems is a national healthcare benefits administrator that partners with employers to design and manage flexible health plans. The company focuses on smarter plan design, responsive service, and customized solutions that improve member experiences while managing costs. As part of the Claims team, you’ll help uphold that standard when claims are challenged.
Schedule
- Full-time, fully remote position
- Standard business hours (specific schedule may vary by team)
- Remote-friendly culture with strong focus on communication and reliability
- Must have cable or fiber internet with at least 100 Mbps download / 25 Mbps upload speeds
What You’ll Do
- Log, track, and monitor all appeals received under the Allied Advocate program
- Review appeals and supporting documentation to determine appropriateness and next steps
- Review Summary Plan Documents to assess the validity of each appeal
- Compose appeal responses when needed and route documentation to business partners for review and resolution
- Communicate with internal departments, clients, and partners regarding appeal status and required information
- Document appeal status and outcomes in Qiclink and related databases
- Coordinate appeal responses with business partners and follow up on aging appeals
- Prioritize incoming referrals and tasks to ensure deadlines and turnaround times are met
- Perform other duties as assigned to support the appeals workflow
What You Need
- Bachelor’s degree or equivalent work experience
- At least 2 years of comprehensive experience handling medical claims appeals
- Strong working knowledge of medical claims processing
- Proficiency with Microsoft Office Suite and ability to learn new systems
- Excellent verbal and written communication skills
- Strong analytical and problem-solving skills
- High level of organization and attention to detail
- Proven time management skills with the ability to meet deadlines consistently
Benefits
- Competitive hourly pay range of $20.00–$21.00, based on experience and qualifications
- Comprehensive Total Rewards package
- Medical, Dental, and Vision insurance
- Life and Disability insurance
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support your remote work setup
If you’re ready to put your claims and appeals experience to work in a fully remote, detail-driven role, this is a strong fit.
The right candidates won’t wait on a role like this—get your application in while it’s open.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 27, 2025 | Uncategorized
If you’re fast on the keyboard, love clean data, and want a stable remote role in healthcare operations, this one is built for you. As an EDI Coordinator, you’ll keep critical eligibility and claims files moving so people actually get paid and covered on time.
About Allied Benefit Systems
Allied Benefit Systems is a national healthcare benefits administrator that partners with employers to design and manage flexible group health plans. The company focuses on smarter benefits, better service, and customized solutions that support both clients and members. As part of the Operations team, you’ll be a key player behind the scenes making sure the data that powers everything is accurate and on time.
Schedule
- Full-time, fully remote position
- Standard business hours (specific schedule may vary by team)
- Remote-friendly culture with strong focus on accuracy, communication, and reliability
- Must have cable broadband or fiber internet with at least 100 Mbps download / 25 Mbps upload speeds
What You’ll Do
- Receive, upload, and download daily EDI files to and from various vendors and internal systems
- Process 837 files and convert them into .txt files for internal use
- Prepare files to be loaded into internal systems for claims processing and payment workflows
- Conduct eligibility checks by matching enrollee and member demographics to the internal master database
- Perform data entry and monitor EDI databases for accuracy and completeness
- Document processing workflows and maintain daily file counts and batch audit records
- Process failed transactions, resolve missing acknowledgements, and route completed claims to the correct internal mailboxes
- Provide EDI support to external trading partners and internal staff
- Handle multiple tasks simultaneously while meeting timelines and accuracy standards
- Perform other duties as assigned to support the EDI and operations teams
What You Need
- High school diploma or GED
- Data entry experience; ability to type at least 6,000 keystrokes per hour with accuracy
- Basic knowledge of Word, Excel, and Access (additional experience with Access and Excel is a plus)
- Strong attention to detail and commitment to accuracy
- Good problem-solving skills and a motivated, self-directed work style
- Ability to handle multiple tasks at once and prioritize effectively
- Comfortable working independently and as part of a remote team
- Able to work in a computer-based, desk-focused environment for extended periods
Benefits
- Competitive hourly pay range of $20.00–$21.00, based on qualifications and experience
- Comprehensive Total Rewards package
- Medical, Dental, and Vision insurance
- Life and Disability insurance
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support your remote work setup
If you’re ready to turn your data entry and EDI skills into a reliable, fully remote role, now’s the time to move.
Your next work-from-home win could start with this application—don’t let it pass.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 27, 2025 | Uncategorized
Support members through complex health journeys while working from home. In this role, you help connect people to the right care, manage benefit partners, and make a real impact on health outcomes and costs.
About Allied Benefit Systems
Allied Benefit Systems is a national healthcare benefits administrator that partners with employers to design and manage flexible, self-funded health plans. The company focuses on delivering smarter, more personalized benefits solutions that improve member experiences and manage costs. As part of the Medical Management team, you’ll help drive better clinical and financial outcomes for members and clients.
Schedule
- Full-time, fully remote position
- Standard business hours (specific schedule may vary by team)
- Remote-friendly culture with strong emphasis on communication and collaboration
- Must have reliable cable or fiber internet with minimum speeds of 100 Mbps download / 25 Mbps upload
What You’ll Do
- Review clinical information, claims, and baseline case details for a variety of health scenarios (Behavioral Health, Wellness, Specialty Rx, Maternity, and more)
- Develop strategic care plans that connect members with specialized vendor partners and Allied Care Clinicians
- Implement care plans by coordinating with members, clients, internal Allied staff, and external partners
- Partner closely with the Clinical Case Management team and other Case Managers to gather clinical information, present cases, and troubleshoot escalated issues
- Communicate with CMS and other entities to obtain essential member information
- Facilitate and maintain relationships with prescription drug vendors, including managing member setup, negotiating pricing when needed, and providing ongoing support
- Document case impacts to highlight cost savings and improved member health outcomes
- Perform weekly and monthly administrative tasks related to Enhanced Case Management
- Act as a liaison between clients, brokers, members, Allied Executives, and various internal departments
- Help identify, troubleshoot, and optimize internal processes across Enhanced Case Management and related teams
- Perform other duties as assigned to support the ECM strategy and operations
What You Need
- Bachelor’s degree or equivalent work experience
- At least 2 years of experience with Group Health Insurance and Self-Funded Health Plans
- Excellent verbal and written communication skills
- Strong interpersonal and customer service skills
- Exceptional organizational skills and attention to detail
- Proven time management skills with the ability to meet deadlines
- Ability to review information, assess issues, and propose viable solutions
- Strong analytical and problem-solving skills
- Experience with Medicare, Medicaid, Case Management, or prescription drug benefits preferred
- Experience in a clinical, social work, or hospital system role is a plus
- Life and Health Insurance Producer License preferred, but not required
- Proficiency with Microsoft Office Suite and comfort learning new software
Benefits
- Salary range of $48,000–$55,000, depending on experience and qualifications
- Comprehensive Total Rewards package
- Medical, Dental, and Vision insurance
- Life and Disability insurance
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support your remote work setup
If you’re ready to use your healthcare benefits expertise to guide members toward better outcomes in a fully remote role, this is a strong next step.
Give your skills a promotion—step into a case management role where your coordination actually changes lives.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 27, 2025 | Uncategorized
Help people get their health benefits handled right, without sitting in a call center all day. In this role, you’re the behind-the-scenes problem solver making sure claims move, issues get resolved, and members actually feel taken care of.
About Allied Benefit Systems
Allied Benefit Systems is a national healthcare benefits administrator partnering with employers to design and manage group health plans. The company focuses on flexibility, service, and customized solutions that help clients control costs while supporting their members. You’ll be part of an operations team that keeps things moving and makes the claims experience smoother for everyone involved.
Schedule
- Full-time, fully remote role
- Standard business hours (specific schedule may vary by team)
- Remote-friendly culture with strong focus on communication and responsiveness
- Must have reliable cable or fiber internet with minimum speeds of 100 Mbps download / 25 Mbps upload
What You’ll Do
- Serve as a liaison between members, internal administrative teams, and clients to ensure smooth claim handling
- Use Outlook and internal systems to communicate claim status and responses to members, agents, and partners
- Investigate open claims to ensure timely processing of payments and advocate for members throughout the process
- Manage and facilitate multiple claim functions, including HRA RX claim reviews, RRTs, special claim requests, and escalations
- Push failed claims over $10K through the IPAO process and track them until completion
- Support the Administrator team as needed and help resolve claim issues across departments
- Process fee claims for Case Management, Enhanced Case Management, HRA Pharmacy claims, and other vendor-related fees
- Demonstrate strong understanding of workflows and business processes to support BPO client service strategy
- Help foster a sense of urgency and accountability so customer expectations are met or exceeded
- Assist with escalations and various ad hoc projects as assigned
What You Need
- Bachelor’s degree or equivalent work experience
- 2+ years of experience in an administrative or data entry role
- Group health insurance/benefits or medical claims experience preferred
- Strong analytical and problem-solving skills, with the ability to prioritize and follow through
- Excellent verbal and written communication skills
- Strong organizational skills and attention to detail
- Proven ability to manage time effectively and meet deadlines in a high-paced environment
- Comfortable working remotely in a computer-based, desk-focused role
- Proficiency with Microsoft Office Suite and ability to learn new systems quickly
Benefits
- Competitive hourly pay range of $23.00–$25.00, based on qualifications and experience
- Comprehensive Total Rewards package
- Medical, Dental, and Vision insurance
- Life and Disability insurance
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support your remote work setup
If you’re ready to bring your detail skills and follow-through to a remote role where operations actually matter, this is your cue to jump in.
Strong candidates move fast on roles like this—don’t overthink it.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 27, 2025 | Uncategorized
Help people get fair outcomes on their medical claims from the comfort of your home. If you’re detail-oriented, love digging into documentation, and want a stable remote role in healthcare benefits, this is in your lane.
About Allied Benefit Systems
Allied Benefit Systems is a national leader in healthcare benefits administration, partnering with employers to design and manage customized benefit plans. The company focuses on improving member experiences, controlling costs, and simplifying the complexity of medical claims. You’ll be joining a team that values accuracy, service, and strong partnerships with clients and vendors.
Schedule
- Full-time, remote position
- Standard business hours (details may vary by team)
- Must have reliable high-speed internet (cable or fiber) with minimum speeds of 100 Mbps download / 25 Mbps upload
- Role requires consistent availability for phone and online communication
What You’ll Do
- Log, track, and monitor all appeals received related to the Allied Advocate program
- Review appeals and supporting documentation to determine appropriateness and next steps
- Analyze Summary Plan Documents to evaluate the validity of appeals
- Compose appeal responses when needed and coordinate final responses with business partners
- Communicate with internal departments, clients, and partners to clarify information and move appeals toward resolution
- Document appeal status and outcomes in the Qiclink system and related databases
- Prioritize incoming referrals to ensure all tasks are completed within required timeframes
- Perform other related duties as assigned to support the appeals process
What You Need
- Bachelor’s degree or equivalent relevant work experience
- At least 2 years of hands-on experience handling medical claims appeals
- Strong knowledge of medical claims processing and ability to analyze complex claim situations
- Proficiency with Microsoft Office Suite and the ability to learn new systems quickly
- Excellent verbal and written communication skills
- Strong analytical, problem-solving, and organizational skills with sharp attention to detail
- Proven time management skills and ability to consistently meet deadlines
- Comfort working in a remote environment and communicating via phone and digital tools
Benefits
- Competitive hourly pay range of $20.00–$21.00, plus Total Rewards package
- Medical, Dental, and Vision insurance
- Life and Disability insurance coverage
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support your remote work setup
Ready to put your claims expertise to work in a fully remote role with real impact? Apply while this opportunity is open.
Your next solid work-from-home move might start here—don’t sit on it.
Happy Hunting,
~Two Chicks…
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