Jobs at Allied Benefit Systems Inc

Sell new business by building broker/consultant relationships, meeting growth targets, positioning Allied's value, managing negotiations, preparing RFPs, and resolving escalated client issues. Execute territory sales strategy and represent the company at industry and civic events.

Prepare, submit, and follow up on medical stop loss reimbursement claims for individual (specific) coverage. Manage documentation, appeals for denials or reductions, reconcile claim activity, coordinate with carriers, brokers, and internal teams, and meet filing deadlines per contract requirements.

Lead Allied's integrated marketing function, owning brand, events, content, lifecycle, and martech. Build scalable programs and teams, align cross-functionally with Sales and Product, manage budgets, measure ROI, and drive pipeline growth and retention for broker and employer audiences.

Lead implementation of operational projects, new products, services, and vendor relationships through PMO frameworks. Develop project plans, track milestones, manage risks and QA, run meetings, report status, guide change management, optimize processes, and ensure timely delivery while collaborating with cross-functional teams and ensuring alignment with PMO standards.

Sell health benefits solutions by building broker relationships, managing negotiations and renewals, processing RFPs, conducting presentations and open enrollments, and providing routine account service for self-funded plans.

Manage daily treasury operations including monthly client reconciliations, new business banking setups and changes, vendor maintenance, VCC/EFT support, positive pay and check tracing. Build and document processes, lead training for new and existing team members, and support Treasury Services team issue resolution.

Lead support and enhancement of Cognizant QicLink: analyze, troubleshoot, test, and resolve software and data issues; implement integrations and system enhancements; support data requests, QA, patch releases, and upgrades; collaborate with business and technical teams to improve performance and reduce defects.

Execute end-to-end group medical premium billing using QicLink: import/validate billing files, generate/distribute invoices, reconcile discrepancies, set up accounts, audit configurations, maintain reporting (Excel/Access/Power BI), partner with AR/AP/Eligibility/Client Services, perform root-cause analysis, and ensure internal controls and billing accuracy.

Supervise and coach claims staff, manage workflows and reports, ensure compliance with HIPAA/HITECH, train new hires, monitor productivity/quality, and support cross-departmental claim payment questions.

Perform daily treasury operations and reconciliations, manage business banking setups/changes, support VCC/EFT and Positive Pay processes, maintain vendors, create processes, and train team members.

Lead delivery of GenAI, predictive modeling, semantic search, and automation across business workflows. Define AI product roadmaps and requirements, coordinate engineering and data science teams, ensure MLOps/cloud deployments, manage stakeholder change and training, and ensure compliance with responsible AI governance and ISO 42001 audit readiness.

Deliver and support inbound/outbound EDI (ANSI X12-834) and claims file implementations, perform EDI mapping and testing, monitor file processing, troubleshoot data discrepancies, coordinate cross-functional stakeholders, and maintain data integration documentation and quality controls.

Prepare, file, and monitor individual stop loss (specific) medical claims for reimbursement; follow up with carriers, handle appeals for denied/reduced reimbursements, retain documentation, train team members, and coordinate priority/high-dollar claims.

Lead data analytics for sales and customer performance: design, develop, and maintain SQL-based ETL and reporting solutions, ensure data quality and governance, build dashboards (Power BI/SSRS), support tech teams on security/access, and analyze healthcare datasets to inform product and program decisions.

Manage a portfolio of self-funded group health plan clients, acting as liaison between clients/brokers and internal teams. Lead implementations, present renewals and employee trainings, ensure ACA compliance, produce and analyze reporting, resolve claims and billing issues, and drive client satisfaction and cross-selling.

Manage an assigned book of self-funded group health plan clients as the day-to-day resource. Serve clients and brokers, produce and analyze reporting, present benefits and compliance, support renewals and open enrollment, troubleshoot processes, and cross-sell Allied solutions to retain and grow accounts.

Support resolution of department escalations by collaborating with internal teams, vendors, and external partners. Manage vendor relationships, document and improve processes, provide training, and act as departmental spokesperson under Senior Liaison guidance. Serve as backup to the Senior Case Management Liaison and perform other duties as assigned.

Lead architecture, design, development, testing, and deployment of internal and external products on the Microsoft stack. Mentor junior developers, perform code reviews, create and maintain CI/CD pipelines, collaborate with stakeholders to resolve blockers, and ensure compliance with HIPAA/HITECH and quality standards.

Work with Claim Operations to analyze current systems and workflows, recommend and document improvements, develop and test applications, assist project planning and implementation, perform data validation and quality control, and resolve program issues.

Manage a book of self-funded group health plan clients as the primary day-to-day resource. Handle client and broker communications, ACA compliance, reporting, renewals, open enrollment project management, presentations, issue resolution, plan performance reviews, and cross-selling of Allied solutions to ensure client satisfaction and retention.