Invoice Fee Specialist
About The Position
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.
Requirements
- Three or more years of medical experience requiring knowledge of medical terminology and procedures required or equivalent combination of education and experience
- Working knowledge of computers and software, including but not limited to Microsoft Office products
- Demonstrated ability to work independently, prioritize workloads, multitask
- Demonstrated ability to work in a fast-paced environment while maintaining accuracy and production requirements
Nice To Haves
- Prior TPA experience preferred
- Develop new or improved current internal processes to improve quality
- Flexible, detailed, and able to successfully adapt to change
- Strong written, oral and telephonic communication skills
Responsibilities
- 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
Benefits
- 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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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
