Allied Benefit Systems

Role Description The Member Advocate will be responsible for all plan member communications in the Allied Advocate Department. Advocate will work with plan members throughout the process starting with patient letter and finishing with call to explain final resolution. Communication may be in written or verbal form. Essential Functions - Confer with members by telephone and/or email to answer questions or provide information in response to inquiries on Allied Advocate claims. - Contact members to respond to inquiries or to notify them of claim investigation results and any planned adjustments. - Coordinate with member and/or client services to obtain a signed HIPAA release to aide with the negotiation process. - Keep records of member and provider interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken. - Obtain and examine all relevant information to assess need for negotiation on balance due issues. - Work with other departments (Account Management, Client Services, Customer Service) as needed to resolve member issues. - Meet and sustain productivity and quality metrics determined by management. - Other duties as assigned. Qualifications - High school diploma or equivalent work experience required. - 1-2 years of customer service experience required. - Insurance knowledge preferred. - Excellent verbal and written communication skills. - Excellent interpersonal and customer service skills. - Proficient with Microsoft Office Suite or related software. - Excellent time management skills with a proven ability to meet deadlines. - Strong analytical and problem-solving skills. - Ability to function well in a high-paced and at times stressful environment. Position Competencies - Accountability - Communication - Customer Service Orientation - Functional/Technical Skills - Quality Focus - Time and Task Management Physical Demands This is standard desk role requiring extended periods of sitting and computer work. Work Environment Remote Benefits - Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend

Role Description The Supervisor, Customer Experience, oversees a team of Customer Experience Specialists (CES) to ensure exceptional service delivery, efficient operations, and continuous improvement. This position is responsible for: - Coaching and mentoring staff - Monitoring performance metrics - Resolving escalated issues - Implementing service strategies that align with company goals, performance guarantees, and key performance indicators - Acting as a liaison between frontline associates and Contact Center leadership - Fostering a positive work environment and driving customer satisfaction through effective leadership and process optimization Qualifications - Bachelor’s degree or equivalent work experience required - At least 3 years’ experience in a Health Insurance and Customer Service call center environment required - Demonstrated supervisor potential (i.e. previous team lead role, project leader, etc.) is required - Proficient in Microsoft Word and Excel programs - Ability to read, analyze and interpret general plan benefits and guidelines - Ability to write reports, business correspondence, and procedures - Ability to effectively respond to questions from management, co-workers, members, providers, and clients Requirements - Lead, coach, motivate, and develop employees through one-on-one meetings, performance appraisals, and growth opportunities - Empower employees to take ownership of tasks and contribute to team goals - Provide clear expectations, training, and resources to support success - Conduct regular team meetings and one-on-ones to foster communication and collaboration - Ensure cross-training and continued development across the team - Monitor and track employee performance, including productivity, quality, attendance, and schedule adherence - Ensure team performance meets or exceeds departmental goals and quality standards - Identify trends and recommend improvements to enhance operational efficiency and reduce executive complaints - Maintain employee schedules, assignments, and training plans - Meet deadlines and turnaround times set by leadership - Partner with contact center leadership and HR to interview, select, and onboard new employees - Collaborate with leadership to proactively address performance or workflow issues - Participate in department/corporate meetings to support program development and service enhancements - Demonstrate commitment to improving the customer experience and resolving service challenges - Promote best practices and implement solutions to streamline workflows without compromising quality - Provide regular performance summaries and insights to contact center leadership - Manage departmental equipment inventory, including headsets, phones, and related tools, ensuring accurate tracking and availability to support daily call center operations - Other duties as assigned Benefits - Competitive Benefit Package including Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend Work Environment This is a remote position. The company believes that great talent can thrive from anywhere, offering flexibility and the comfort of working from home. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

Role Description The Billing Specialist II processes and audits client invoicing, client setups/changes, and rate sheet reviews to ensure timely invoice generation and adherence to key performance standards and policies. This role involves managing electronic billing data, verifying client and vendor financial information, communicating with internal stakeholders, and potentially providing mentorship to junior staff. Essential Functions - Accurately process monthly invoices for large volume of assigned groups - Review monthly billing eligibility adjustments and ensure accurate processing of member terms and enrollments - Configure and audit new accounts for our ASO book of business - Renewal rate sheet review with audit of annual fees and rates for existing book of business - Create/Maintain Excel spreadsheets to track services/activity for assigned groups - Assist in New Hire and Group Training - Maintain Access Database table data to track services/activity for several clients - Address and resolve complex billing discrepancies and customer inquiries - Serve as a resource and mentor for junior billing staff - Ensure all billing activities comply with corporate policies and procedures - Other duties as assigned Qualifications - High School Degree or equivalent required - College degree preferred - Minimum 3 years of Billing Administration within a fast-paced environment required - Strong grasp of billing procedures and coding standards - Extremely detail-oriented with superior analytical skills - Experience in accounting, billing, accounts receivable, and understanding financial reporting is strongly preferred - Strong ability to research and resolve complex billing issues - Third Party Billing Administration preferred - Intermediate to Advanced experience with Word, Excel, Outlook, and Access preferred - Ability to scrutinize large data sets to ensure accuracy and identify trends - Expertise in using billing and financial software - Strong interpersonal and communication skills to effectively work with clients and internal teams - Familiarity with Microsoft Excel, databases, and potential SQL for data analysis and reporting Requirements - Accountability - Communication - Customer Service Orientation - Functional/Technical Skills - Quality Focus - Time and Task Management Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote Benefits - Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend

Role Description The Billing Specialist I will assist in file imports using multiple systems, state reporting calculation and filing, multiple types of client invoicing, client setups/changes, client audits and creating/maintaining reports. Essential Functions - Process and submit accurate and timely invoices to clients - Follow up on outstanding payments and resolve any billing discrepancies - Communicate with clients regarding billing inquiries and payment status - Maintain accurate records of all billing and collection activities - Assist with month end closing and reporting - Collaborate with other departments to ensure accurate and timely billing - Set up new accounts for our new book of business - Change accounts for existing book of business - Audit accounts to ensure setup/changes were allocated correctly - Create/Maintain Excel spreadsheets to track services/activity for several clients - Maintain Access Databases to track services/activity for several clients - Other related duties as assigned Qualifications - High school diploma or equivalent - 2+ years of experience in billing and collections - Excellent communication and problem solving skills - Proficient in Microsoft Office and accounting software - Ability to work independently and as part of a team - Strong attention to detail and accuracy Requirements - Accountability - Communication - Customer Service Orientation - Functional/Technical Skills - Quality Focus - Time and Task Management Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote Benefits - Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend

Role Description The Account Manager has full command of an assigned book of Allied clients. The position involves management of group health plans which are self-funded. The Account Manager will serve as the day-to-day resource for clients and brokers, will prepare and submit reporting for key accounts, implement plan changes, perform client presentations, and review plan performance. Communicating compliance requirements and evaluating benefit plans is essential. The position is responsible for the overall client satisfaction of the account. Essential Functions - Act as the liaison between the employer and broker, Client Executive, and various Allied departments involved in administering self-funded group health plans. - Provide communication regarding industry and legislative updates and ACA compliance. - Manage and resolve escalated employee issues. - Conduct quarterly meetings to review plan performance, build client relationships, and ensure overall satisfaction leading to client retention. - Communicate changes internally regarding benefit plan design, financial information, and vendor partner changes. - Prepare and host employee presentations, employer portal training, and executive summary report reviews. - Troubleshoot, identify, and improve internal processes with various Allied departments. - Produce and analyze ad hoc reporting when requested from a client, broker, or Client Executive. - Help facilitate the renewal of existing cases by managing claims, producing updated plan documents, and project managing open enrollment for current employer groups. - Cross sell various Allied solutions to existing clients. - Other duties as assigned. Qualifications - BA/BS or equivalent work experience required. - At least three years’ experience in an account management role required. - Excellent working knowledge of employee medical benefit plans required. - Experience with group health insurance and self-funded health plans preferred. - Excellent written and verbal communication skills. - Intermediate level work experience with Microsoft Office, Word, Excel, Access, and PowerPoint software applications. - Public speaking and an ability to present benefits and compliance. - Organized. Requirements - Life and Health Insurance Producers license preferred. Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote. Here at Allied, we believe that great talent can thrive from anywhere. Our remote-friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. Benefits - Competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance. - Generous Paid Time Off. - Tuition Reimbursement. - EAP. - Technology Stipend.

Role Description The Treasury Services Specialist is the subject matter expert concerning the daily Treasury Services processes. This role will perform typical Analyst level tasks while supporting the Treasury Services team with any day to day issues and concerns. This position is responsible for building out processes and providing additional training to the Treasury Services team. Essential Functions - Complete Monthly Reconciliations of client accounts through Great Plains - Process New business banking setup (BPO and ASO) - Make existing business banking changes (BPO and ASO) - Vendor maintenance for print fulfillment - VCC/EFT Implementation and support - Complete Check Tracer processes - Positive Pay submission - Create and implement new processes as needed - Lead new hire and existing team member training as needed - Other duties as assigned Qualifications - High School Diploma or equivalent work experience required - A minimum of 2 years’ experience as a Treasury Analyst required - Must be detailed oriented - Excellent written and verbal communication skills required - Excellent organizational and time management skills required - Proficient with Microsoft Office Suite, Excel, Word, or similar software required - Experience with financial management systems, such as Great Plains or similar - Good computer skills with programs such as MS Excel, Access, and Power BI - Exceptional analytical and problem solving skills - Strong financial and mathematic abilities - Strong time management and organizational abilities Requirements - Accountability - Communication - Customer Service Orientation - Functional/Technical Skills - Quality Focus - Time and Task Management Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote Benefits - Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend

Role Description This Operations Implementation Manager is responsible for managing the implementation of new products, services, and vendors. Your responsibilities will encompass project management, coordination with internal and external stakeholders, and ensuring that project objectives are met. Your collaborative efforts will help streamline project operations and contribute to the overall success of the team. Essential Functions - Manage the implementation of new products, services, compliance initiatives, and vendor relationships from inception to completion. - Develop and maintain detailed project plans and documentation, track progress, and ensure that all milestones are met. - Collaborate with internal and external project partners, acting as a liaison between different departments and teams. - Contribute to the comprehensive assessment of projects to determine compliance, operational requirements, and any technological needs. - Identify potential project risks and assist in implementing contingency plans, in consultation with the Senior Implementation Manager. - Support the implementation of quality assurance policies and procedures to maintain project integrity. - Provide support and take the lead in organizing and facilitating both internal and external project meetings, contributing to their effective and efficient execution. - Guide teams through the change process, ensuring all stakeholders are informed and aligned with new implementations. - Provide regular status reports and metrics to stakeholders, keeping all parties informed of project progress. - Collaborate on reviews of existing processes, procedures, and workflows to propose enhancements when necessary. - Demonstrate a strong understanding of Allied’s business requirements. - Gather, analyze, and research information that may impact the project. - Meet established due dates and deadlines. - Track project performance and analyze lessons through learned documents. - Demonstrate a strong understanding of Allied business needs with respect to all ASO processes and workflows, with special attention to technological or programming impacts. - Other duties as assigned. Qualifications - Bachelor’s degree or equivalent work experience required. - At least 5 years’ experience in managing projects, including planning, execution, and monitoring within the healthcare industry is essential. - At least 3 years proven ability to lead cross-functional teams, set project goals, and ensure project success. - Strong verbal and written communication skills for effective collaboration with stakeholders, team members, and external partners. - Experience in reviewing and optimizing existing processes and workflows. - Experience in identifying issues, troubleshooting problems, and finding effective solutions during project implementation. - Strong project management skills, including the use of project management software. - Experience with workflow and flowcharting tools such as Visio, SmartDraw, etc. required. - Proficient in Microsoft Office Suite, including Microsoft Excel, OneNote, and Project, as well as the ability to understand and adapt to new software programs. Position Competencies - Accountability - Analytical Thinking - Collaboration - Communication - Customer Focus - Functional Expertise - Initiative Physical Demands - This is an office environment requiring extended sitting and computer work. Work Environment - Remote Benefits - Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend

Role Description The Prompt Engineer will be responsible for optimizing, evaluating, and advancing the performance of AI-driven agents, such as chatbots and autonomous workflows to ensure they deliver accurate, efficient, and high-quality outcomes. This role combines analytical thinking, user experience insight, and technical expertise to monitor agent behavior, identify improvement opportunities, and implement enhancements that align with business goals. Essential Functions - Define and document required AI agent behavior, including edge cases, compliance constraints, escalation expectations, and response quality targets. - Convert benefits workflows and policy rules into implementable use cases, key data fields to capture, and testable scenarios that can be built and verified. - Maintain a clear mapping from requests to delivered behavior so gaps are visible and reviewable. - Drive stakeholder reviews and acceptance of behavior, flows, and decision logic before changes ship. - Craft and iterate prompt instructions and response rules that produce accurate, consistent answers in a regulated benefits context. - Build reusable prompt patterns and maintain a controlled prompt library with clear version history. - Review real interactions to identify failure modes, then adjust prompts, context, and fallbacks to improve outcomes. - Partner with engineering and QA to define regression test coverage and release criteria for prompt and flow changes. - Define the agent’s voice and interaction style so it is professional, on-brand, and easy for members and providers to follow. - Design multi-step conversation paths that handle ambiguity, corrections, and interruptions without losing the user. - Define when the agent should answer, when it should ask clarifying questions, and when it should hand off to a live person. - Validate that wording, terminology, and risk posture match benefits operations expectations. - Define how the agent should use plan documents to answer questions, including what to do when source material is missing or ambiguous. - Partner with contact center and workforce management teams to align the agent experience with SOPs and ensure workflows stay current as procedures change. - Partner with engineering on query shaping and grounding so document-based answers stay tied to supporting text. - Own the gold standard definition of intended agent behavior after launch, so teams can support and improve it without relying on vendor or institutional knowledge. - Maintain the core operating artifacts used day to day: use case catalog, flow maps, escalation rules, prompt library, and a running list of known failure modes. - Create lightweight training and working sessions for internal support partners and business SMEs. - Establish a change process for updating prompts and flows, including testing expectations, approvals, and version history. - Requirements and functional specifications for prioritized conversational AI use cases. - Use case catalog and key information requirements mapped to approved scenarios. - Conversation flow designs that include fallbacks, error handling, and escalation. - Versioned prompt library with testing notes and a clear change history. - UAT scripts and acceptance criteria, plus defect tracking through resolution. - Maintain a curated set of golden records and test cases that represent critical scenarios and edge cases and use them to support automated regression and quality testing. - Operator documentation that enables internal support and ongoing improvement. - Post-launch performance monitoring, including top failure modes and improvement plans. Qualifications - Bachelor’s degree in Computer Science, Math, Statistics, UI/UX, Process Design or equivalent work experience required. - 6+ years of experience across business analysis, conversational AI, UX writing, and related product roles. - Direct experience designing and improving chatbots, voicebots, IVR modernization, or contact center automation. - Ability to translate business workflows into clear user requests, key information to capture (e.g., member identifiers, dates, plan options), and end-to-end conversation paths that engineering can build and QA can test. - Strong prompt design skills and a test-and-learn mindset using real interaction data. - Strong writing and editing skills with comfort in a regulated, customer-facing environment. - Comfort operating with ambiguity in a new and evolving role, and able to create processes and standards where none exist. - Ability to collaborate with cross-functional stakeholders and external partners. - Shipped conversational AI experiences in voice and/or contact center environments. - Experience working with plan documents, knowledge bases, and policy text in regulated environments. Able to translate source material into grounded answers and guardrails. Position Competencies - Accountability - Analytical Problem Solving - Collaboration - Execution and Delivery - Quality and Risk Management - Systems Thinking - Technical/Functional Expertise Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home; while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. Benefits - Competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance. - Generous Paid Time Off. - Tuition Reimbursement. - EAP. - Technology Stipend.

Role Description The Senior Data Analyst is responsible for delivering highly visible inbound and outbound EDI projects for the data operations team at Allied. This includes: - Playing a key role in the implementation of new trading partners. - Configuration of inbound and outbound ANSI X12-834 eligibility files and standard and custom data extracts. - Maintenance of existing trading partner files. - Resolving existing trading partner file issues. Technology platforms for project delivery include QicLink and new data integration tools which support client eligibility (ANSI X12-834 file format). This role requires: - In-depth knowledge of eligibility data exchange. - Expert knowledge of ANSI X12-834 file format and reading/understanding file spec/requirement documentation. Qualifications - Bachelor’s degree or equivalent work experience required. - 3-5+ years of experience working with inbound and outbound ANSI X12 834 EDI files, including expert level proficiency with the X12 834 format. - Working knowledge of data management, data warehousing, and coding languages. - Required experience with SQL and Microsoft Power BI, along with strong computer skills, including proficiency in the Microsoft Office Suite (Word, Excel, etc.). - Excellent knowledge of data integration programs involving all components including source systems, ETL, data quality/integrity, database, and delivery mechanisms and EDI business processes, practices, and procedures within healthcare environment. - Strong work ethic and positive attitude with exceptional ability to manage multiple projects across functional teams in a fast-paced environment. - Strong communication skills (both verbal and written) and an ability to provide recommendations on data integrations and applications. - Strategic, conceptual analytical thinking and decision-making skills. - Ability to advise on complex technical matters to all stakeholders; ability to communicate effectively with management. Requirements - Lead outbound file implementation projects end to end, including project initiation, defining timelines, coordinating internal resources, leading or participating in project meetings, and managing ongoing communications with vendors and internal Allied stakeholders. - Own ANSI X12 834 eligibility file implementations, ensuring accurate configuration, testing, and smooth transitions to production. - Lead additional EDI or data extract implementations as required. - Serve as a primary point of contact for eligibility (834) questions, implementations, production issues, and project related updates for both internal teams and external partners. - Independently navigate, interpret, and troubleshoot 834 formatted files, including completing detailed data mapping, supporting file testing, and resolving complex data and formatting issues. - Leverage internal testing, validation, and monitoring tools to execute file testing, document configurations, and maintain a single source of truth for eligibility and EDI files across teams and vendor partners. - Monitor file processing status and performance through eligibility audit reports and other reporting mechanisms, proactively identifying risks, discrepancies, or trends. - Review, investigate, and support resolution of data discrepancies related to eligibility, accumulators, or downstream impacts, coordinating closely with customer service, account management, IT, and vendor/client contacts. - Coordinate with internal teams to ensure implementation milestones and delivery timelines are met, escalating risks or blockers as needed. - Troubleshoot and escalate complex data or file processing issues with internal and external partners, providing clear documentation and recommended next steps. - Support data quality initiatives by following established controls and contributing to the improvement of testing, documentation, and operational processes. - Act as a trusted partner to Data Operations leadership by owning assigned initiatives, providing status updates, and contributing subject matter expertise to broader data management efforts. - Other duties as assigned. Benefits - Competitive Benefit Package including, but not limited to: - Medical, Dental, Vision, Life and Disability Insurance. - Generous Paid Time Off. - Tuition Reimbursement. - EAP. - Technology Stipend. Physical Demands - This is a standard desk role requiring extended sitting and computer work. Work Environment - Remote work environment. - Reliable internet service is essential for staying connected and productive.

Role Description The Senior Software Engineer will be responsible for architecting and designing internal and external products for Allied. Problem solving and finding ways to create scalable software while mentoring junior developers. As a technical lead, you will be responsible for resolving issues and ensuring the success of projects assigned to your team. Essential Functions - Collaborate with a team comprised of technical and non-technical members to support completion of projects in a timely fashion. - Be willing to work on a roadmap that includes business and technical initiatives. - Provide technical leadership to junior developers. - Work with managers and stakeholders to resolve blockers that impact project timelines. - Partake in code review to ensure Allied’s code reviews are being adhered to. - Work closely with the team to design, develop, test, and deploy. - Create automated processes to implement/maintain CI/CD pipelines. - Meet Allied’s expectations for productivity, quality, and goal accomplishment. - Work closely with managers to formulate technical strategies for the team. - Adhere to, and apply all applicable privacy and security laws, including but not limited to HIPAA, HITECH and any regulations promulgated thereto. - Other duties as assigned. Qualifications - Bachelor’s degree in computer science or information technology or equivalent work experience required. - Certifications and Licenses: none required, though MCSA, other Microsoft certifications, and HIPAA Awareness/Security are preferred. Requirements - 7+ years’ experience developing software using Microsoft’s platform required. - 3+ years in a software developer lead role required. - Strong understanding of SOLID and OOP. - Ability to collaborate well with team members. - Understanding of SDLC lifecycle. - Extensive experience coding in C#, ASP.NET/MVC, Web APIs, WCF. - Experience with SQL Server Development – creating and modifying stored procedures. - Display strong technical experience in Microsoft Stack. - Familiarity with Azure DevOps preferred. - Familiarity with Azure or AWS cloud environments preferred. - Familiarity with API Gateway patterns preferred. Benefits - Medical, Dental, Vision, Life and Disability Insurance. - Generous Paid Time Off. - Tuition Reimbursement. - EAP. - Technology Stipend. Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote. Here at Allied, we believe that great talent can thrive from anywhere. Our remote-friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.