Imagine360 is seeking an Invoice Fee Specialist to join the team! The Invoice Fee Specialist is responsible for reviewing, validating, and processing Pharmacy Benefit Manager (PBM) vendor invoices to ensure accuracy, completeness, and compliance with contractual agreements. This role plays a critical part in financial oversight by verifying billed fees, identifying discrepancies, and ensuring proper allocation of costs related to pharmacy benefit administration. The analyst works closely with PBM vendors and internal departments to resolve billing issues, support month-end closing, and maintain strong internal controls.
Position Location: 100% remote
Responsibilities include but are not limited to:
Review and process PBM vendor invoices for accuracy, completeness, and contract compliance
Verify billed fees against fee schedules, service agreements, utilization reports, and supporting documentation
Identify and resolve discrepancies, including overcharges, duplicate fees, and missing or incorrect documentation
Reconcile invoice amounts with claims data, enrollment counts, service periods, and contract terms
Ensure proper allocation of administrative fees, per-employee-per-month (PEPM) charges, and claim-related costs
Coordinate with PBM vendors to resolve billing issues, corrections, and adjustments in a timely manner as well as internal communication with the group assigned Relationship Manager
Prepare approved invoices for payment processing and internal authorization
Maintain detailed records, documentation, and audit trails for invoice reviews and approvals
Support month-end close and financial reporting related to TPA and PBM expenses
Ensure compliance with internal controls, accounting policies, and contractual obligations
Serves as back up within Support Services team
Required Experience/Education:
Prior TPA experience preferred
Three or more years of medical experience requiring knowledge of medical terminology and procedures required or equivalent combination of education and experience
Skills and Abilities:
Develop new or improved current internal processes to improve quality
Flexible, detailed, and able to successfully adapt to change
Working knowledge of computers and software, including but not limited to Microsoft Office products
Strong written, oral and telephonic communication skills
Demonstrated ability to work independently, prioritize workloads, multitask
Demonstrated ability to work in a fast-paced environment while maintaining accuracy and production requirements
What can Imagine360 offer you?
Multiple Health plan options
Company paid employee premiums for disability and life insurance
Parental Leave Policy
20 days PTO to start / 10 Paid Holidays
Tuition reimbursement
401k Company contribution
Company paid Short & Long term Disability plus Life Insurance
Professional development initiatives / continuous learning opportunities
Opportunities to participate in and support the company's diversity and inclusion initiatives
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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.
Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**