Imagine360 · 3 hours ago
Contract Configuration Specialist- Part time
United States
Part-time, Contract
Remote
New Grad, Entry LevelImagine360 is a health plan solution company seeking a Contract Configuration Specialist (Part Time) to join their team. The Specialist will be responsible for daily maintenance of Tax IDs for contracts, auditing claims, and collaborating with internal teams to resolve issues.
Health CareHealth InsuranceInsurance
Responsibilities
Daily Tax ID (BASELoad) maintenance for affiliating new providers to Contracts in the internal systems
Review and audit manual priced claims and ensure correct Direct Contract allowable is applied
Work claims in assigned hold queues
Audit and maintain yearly fee schedule updates as assigned
Create and maintain provider roster additions, terminations and updates on assigned contracts
Aid the Supervisor of Configuration Contracting as needed
Field and respond to requests from internal teams on inquiries from providers, clients, brokers, and vendors
Collaborate cross-functionally on any issues to ensure that provider needs are met, and issues are resolved
Gather data for research, problem solving, and other miscellaneous purposes
Produce, analyze, and disseminate reports as needed
Perform clerical functions as assigned
Provide timely and thorough follow to internal customers
Appropriately escalate difficult issues up the chain of command
Act as a role model in demonstrating the core values in customer service delivery
Participate in internal team meetings
Recognize and alert appropriate supervisors of trends that fall outside of quality parameters
Perform self-quality monitoring to develop and execute plans to meet established goals
Provide ongoing feedback to help optimize quality performance
Qualification
Required
High School Diploma or GED required
Knowledge and experience with medical contracts and medical insurance claims
Research oriented
Analytical and ability to multitask and manage time effectively
Experience working in a managed care and health care environment and familiarity with Professional Provider and/or Facility reimbursements
Experience creating fee schedules
Experience with contract loading systems which involve interpreting and programming reimbursement methodologies
Understanding of complex provider contracts
Manual claim review pricing required
Knowledge of binding terms and provisions in a contract
Functional knowledge of payment methodology
Preferred
College degree preferred
Medical coding experience is a plus
Medicare and Commercial reimbursement methodologies a plus
Company
Imagine360
Imagine360 is an integrated health plan addressing one of the greatest challenges on behalf of self-funded employers: healthcare costs are harming the bottom line, they're increasingly unaffordable for employees, and the experience remains poor.
Founded in 2003
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Jeff Bak
President & CEO
Recent News
bloomberglaw.com
2025-08-26
2025-07-31
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