Job Description

Job Location: Allied Benefit Systems - CHICAGO, IL 60606
Position Type: Full Time
Salary Range: $55,000.00 - $60,000.00 Salary
Job Category: OperationsPOSITION SUMMARY
The Project Analyst supports the claims operations team by reviewing and interpreting healthcare claim files (837 and 835), analyzing daily reports, and facilitating communication between Claim Operations and health plan partners including Anthem and Blue Shield. This role is critical in ensuring data accuracy, timely issue resolution, and seamless coordination across stakeholders.
ESSENTIAL FUNCTIONS
- Analyze and validate inbound and outbound 837 (institutional/professional) and 835 (remittance advice) files.
- Identify discrepancies, formatting issues, and data integrity concerns.
- Collaborate with EDI, Claims Team, and other internal departments to resolve file-related errors and escalations.
- Process File adjustments or resolve utilizing vendor portals and tools
- Monitor and analyze daily operational reports related to claims processing, payment reconciliation, and error tracking.
- Monitor daily inventory reports from health plan partners to ensure turnaround timeframes are met.
- Develop insights and trends to support performance improvement and compliance.
- Serve as the primary point of contact between Claim Operations and health plans
(Anthem, Blue Shield).
- Facilitate regular status meetings, escalate issues, and ensure timely resolution of claim-related concerns.
- Document and track communications, decisions, and action items.
- Recommend enhancements to claims workflows and reporting tools.
- Support implementation of new processes or systems impacting claims data exchange.
EDUCATION
- Bachelor’s degree in related discipline or equivalent work experience.
EXPERIENCE AND SKILLS
- 3+ years of experience in healthcare claims processing, claims analysis, preferably with exposure to 837/835 files.
- Strong understanding of HIPAA transaction standards and EDI formats.
- Experience working with TPAs and major health plans (Anthem, Blue Shield preferred).
- Proficiency in Excel and data visualization tools is a plus.
- Excellent communication, organizational, and problem-solving skills.
- Familiarity with claims adjudication systems.
- Ability to manage multiple priorities in a fast-paced environment.
- Strong attention to detail and commitment to data accuracy.
POSITION COMPETENCIES
- Job Knowledge
- Time Management
- Accountability
- Communication
- Initiative
- Customer Focus
PHYSICAL DEMANDS
- This is a standard desk role – long periods of sitting and working on a computer are required.

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.
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.