Client Services Specialist; Healthcare ; Fully Remote

Position: Client Services Specialist (Healthcare Benefits) - Fully Remote
Category Account Management & Client Services## Description POSITION SUMMARY The Client Service Representative delivers responsive, accurate, and professional service to Allied clients, including employer and HR representatives, brokers, and other benefit plan partners. Serving as a primary point of contact, this role owns client inquiries from initial request through resolution, coordinates with internal departments, and provides clear, timely follow-up. The position supports a positive client experience by demonstrating strong knowledge of medical claims, sound judgment, attention to detail, and a consistent commitment to service excellence.

WORK SCHEDULE
* ** Training schedule: 8:00 a.m. to 4:30 p.m. Central Time for the first six weeks of employment.**
* ** Regular schedule after training: 10:30 a.m. to 7:00 p.m. Central Time.
*** Consistent availability during the assigned schedule is required to support clients and business needs.

ESSENTIAL FUNCTIONS
* Serve as the primary liaison between clients and brokers and the Allied executives and departments that support the benefit plan.
* Manage client inquiries and service issues from receipt through resolution, providing timely, accurate, professional, and courteous communication.
* Research claim-related questions, coordinate with Claims, Eligibility, Account Management, and other internal teams, and clearly communicate outcomes and next steps.
* Promptly escalate client complaints, service concerns, and unresolved issues to the appropriate department while maintaining ownership of follow-up.
* Provide clients and brokers with updates regarding claim issue resolution, reporting, relevant industry developments, and legislative information as directed.
* Support Account Managers by assisting with client communication, claim reviews, reporting needs, issue tracking, and follow-up activities.
* Complete month-end follow-up by reviewing and closing open claim issues and documenting final resolutions.
* Build collaborative relationships across Claims, Eligibility, Account Management, and other internal teams to promote efficient service delivery.
* Identify recurring service issues and process gaps, recommend improvements, and partner with internal departments to strengthen the client experience.
* Support retention and renewal efforts for existing clients through effective management of claim reviews, open issues, and service-level expectations.
* Maintain complete, accurate, and timely documentation of client interactions, issues, resolutions, and required follow-up.
* Protect confidential member, client, and benefit plan information and follow applicable privacy, security, and departmental procedures.
* Perform other duties and special projects as assigned.

EDUCATION
* High school diploma or GED required.
* Associate or bachelor's degree preferred.

EXPERIENCE AND SKILLS
* At least one year of medical claims experience required.
* Hands-on experience and working knowledge of
** HCFA/CMS-1500 and UB-04 medical claims, including CPT codes, required**.
* Experience researching, processing, or resolving medical claims strongly preferred.
* Previous client service or customer service experience in healthcare, benefits administration, insurance, or a related environment preferred.
* Working knowledge of medical claims terminology, claim status, benefit plan administration, and issue-resolution processes.
* Strong client service skills with the ability to remain professional, empathetic, and solution-focused during complex or sensitive interactions.
* Excellent verbal and written communication skills, including the ability to explain claim information and next steps clearly to clients and brokers.
* Strong analytical and problem-solving skills with the ability to…