Overview
An organization is seeking an Invoice Fee Specialist to join their team remotely. This role involves reviewing, validating, and processing Pharmacy Benefit Manager (PBM) vendor invoices to ensure accuracy, completeness, and compliance with contractual agreements. The specialist will play a key role in financial oversight by verifying billed fees, identifying discrepancies, and ensuring proper allocation of costs related to pharmacy benefit administration. Collaboration with PBM vendors and internal departments is essential to resolve billing issues, support month-end closing, and maintain strong internal controls.
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 such as 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 and internal Relationship Managers to resolve billing issues, corrections, and adjustments promptly
- 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 Third Party Administrator (TPA) and PBM expenses
- Ensure compliance with internal controls, accounting policies, and contractual obligations
- Serve as backup within the Support Services team
Requirements
- Three or more years of medical experience requiring knowledge of medical terminology and procedures, or an equivalent combination of education and experience
- Prior TPA experience preferred
Skills and Abilities
- Ability to develop new or improve existing internal processes to enhance quality
- Flexibility, attention to detail, and adaptability to change
- Proficient with computers and software, including Microsoft Office products
- Strong written, oral, and telephonic communication skills
- Ability to work independently, prioritize workloads, and multitask effectively
- Capability to maintain accuracy and meet production requirements in a fast-paced environment
Compensation & Benefits
- Multiple health plan options
- Company-paid employee premiums for disability and life insurance
- Parental leave policy
- 20 days of paid time off to start, plus 10 paid holidays
- Tuition reimbursement
- 401(k) company contribution
- Company-paid short and long-term disability insurance plus life insurance
- Professional development initiatives and continuous learning opportunities
- Opportunities to participate in and support diversity and inclusion initiatives
Location
- This position is 100% remote
Equal Opportunity
The employer is an equal opportunity organization. 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.