The Appeals Analyst is responsible for monitoring and tracking the status of appeals as they relate to Allied's Cost Containment program. The position involves reviewing appeals for appropriateness, documenting the claim specifics into the current software and routing documentation to business partners for review/resolution. ESSENTIAL FUNCTIONS Independently review and an

The Mental Health Parity Analyst will be responsible for a broad array of areas associated with compliance under The Mental Health Parity and Addiction Equity Act. Working both independently and in collaboration with other departments, the Mental Health Parity Specialist will gather and provide the necessary information and data for successful completion of the comparativ

The Assistant Claim Specialist is an entry level position for claim processing. This person will use independent judgement and discretion to review, analyze, and make determinations regarding payment, partial payment, or denial of medical and dental claims, as well as various types of invoices, based upon specific knowledge and application of each client's customized plan

This position is responsible for facilitating the successful implementation of new products, services, compliance initiatives, and vendor relationships. The position will write and maintain project plans, requirements, timelines, and process documents, and will assist with leading project meetings and providing stakeholder updates. The position will work closely with cros

This position is responsible for setup and day to day operations of Allied's eligibility services technology platforms. These technology platforms include the following Allied's eligibility system of record, client web based eligibility maintenance portal, and X12 834 electronic data interchange (EDI). The eligibility specialist coordinates data transfers, processes data

The Repricing Coordinator is responsible for re pricing medical (CMS1500, UB04) and dental claims using multiple applications to obtain discounted rates. ESSENTIAL FUNCTIONS Repricing of CMS1500 and UB04 forms for various PPO networks. Ability to use several different computer applications to obtain the information needed to correctly re price a claim. Ability to key clai

The Claims Operations Supervisor will be responsible for various facets of the Refund, Prompt Pay and Disability departments, including inventory management of responsible departments. Provide guidance and direction to team members, as well as implement workflows, as needed. Act as the primary contact for handling and prioritizing any questions and issues from other depar

This position will be responsible for drafting Plan Documents for group health plans. Additionally, they will maintain a detailed database tracking the history of all group health plan revisions. The Benefit and Compliance Administrator will also be responsible for organizing plan documents online. ESSENTIAL FUNCTIONS Review all aspects of the templates and data submissio

The Account Manager has a full command of an assigned book of Allied clients. The position involves management of group health plans which are self funded. This position serves as a direct resource to Allied's Account Management Teams and specifically the Account Executive who acts as team lead. The Account Manager will help identify appropriate carriers, managed care net

The Claims Operations Supervisor is responsible for various facets of the Refund, Prompt Pay and Disability departments, including inventory management of responsible departments. Provide guidance and direction to team members, as well as implement workflows, as needed. Act as the primary contact for handling and prioritizing any questions and issues from other department

The Case Management Liaison is responsible for assisting with the management of internal and external relationships and department escalations under the support of the Senior Case Management Liaison. The role requires the ability to effectively communicate and collaborate with internal and external stakeholders and the ability to apply complex problem solving to address i

The BPO Bank Reconciliation Analyst is responsible for weekly and monthly reconciliations of financial accounts. Applicants should possess strong analytical skills in order to independently navigate and reconcile financial data across different systems. The position requires daily interaction with internal team members across various departments and a curious problem solv

Will be primary claims department trainer. In this role you will use independent judgment and knowledge to determine training needs and perform all aspects of training for the Claim Department. Training will include policies, procedures, and QicLink system training for new hires as well as experienced staff. ESSENTIAL FUNCTIONS Work closely with the Audit Team and departm

Senior, Funding Analyst organizes, delegates, and problem solves day to day workflows of the ASO Funding team. Major responsibilities include training staff on departmental processes, researching and responding to advanced internal and external inquiries regarding claim funding and recommending and implementing process improvements. When necessary, this position supports

The Network Liaison is responsible for implementing appropriate networks/vendors for Allied clients. ESSENTIAL FUNCTIONS Responsible for submitting new setup paperwork, maintaining, updating, and testing of new networks to ensure they meet the needs of the client. Work closely with the Implementation Success Mangers and Coordinators to ensure networks are assigned properl