Imagine360 is seeking a Member Benefit Specialist to join the team!  In this position you will be receiving inbound calls from members, to help with inquiries involving benefit plans. You will act as an advocate for members by providing knowledge, expertise, and support to members, guiding them throughout their healthcare experience. By educating members on resources and benefits available to them, the Member Services Professional plays a key role in the member's journey navigating the complexities and cost of healthcare. Position Location: 100% remote Responsibilities include but are not limited to: - Deliver above and beyond service over multiple channels including phone, email, portal inquiries, etc. by acting as a single point of contact, maintaining ownership of member resolution - Become an expert in benefit administration, Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs) and alternative benefit payment designs specifically reference based pricing - Guide understanding of health benefit coverage including accumulators, explanation of benefits, out of pocket maximums, and reimbursement levels - Take ownership of the member experience from beginning to end, reducing handoffs to others to ensure consistency and resolution - Anticipate the needs of members and conduct research on members' behalf to resolve issues - Educate members on pre and post services in conjunction with benefit to optimize the member experience throughout their healthcare journey - Collaborate with internal and external partners to ensure a best-in-class service delivery - Resolve member complaints - Treat all calls and correspondence using procedures and paying attention to the sections relating to HIPAA guidelines and the HIPAA Privacy Rules - Complete provider research, appointment scheduling, medical record retrieval and all other non-clinical duties assigned within applicable timeframes in compliance with Policy & Procedures - Accurate documentation in appropriate software, including CaseTrakker, Macess, etc. Required Experience/Education: - High school diploma or GED. - 1+ year healthcare industry work experience. - Experience in delivering client-focused solutions based on customer needs within direct member contact and education. - Ideally virtual/telephonic, in-person experience with the public. - 1+ year with telephonic verification of medical benefits. - 2+ years healthcare experience i.e. carrier, TPA, patient advocate, or other benefits focused role. - Medical claims exposure (ICD-9/10 coding, CPT coding, and medical claim forms). Skills and Abilities: - Proficient in Microsoft Outlook, Word and Excel - Service-driven mindset - Aptitude for learning and retention - Advanced soft skills with a high level of emotional intelligence - Strong written communication skills 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 Want to see our latest job opportunities? Follow us on  LinkedIn 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**

OneSource Virtual (OSV) has helped more than 1,000 Workday customers take their teams from transactional to transformational with innovative technology and services for HR, payroll, and finance. Founded in 2008, OSV is the leading exclusive provider of Business-Process-as-a-Service (BPaaS) solutions for Workday, delivering services with unparalleled choice, unwavering commitment, and uncompromising support. OneSource Virtual’s global headquarters is located in Dallas, Texas, with additional locations across North America and Europe. Find your company’s solution at www.onesourcevirtual.com. Position Summary OneSource Virtual is seeking a Director of Enterprise Architecture to lead technology design and implementation across our Payment and Tax product lines. The ideal candidate combines deep enterprise architecture experience with hands-on fluency in AI-assisted development practices. This leader will set the architectural direction for a high-velocity engineering organization that processes over $200 billion in compliant payments annually, and will play a central role in advancing our AI-first development culture across 90+ engineers. Essential Functions & Responsibilities Architecture & Technical Leadership - Design, document, and guide implementation of technology solutions across multi-team development projects in an agile environment - Own the enterprise architecture roadmap for Payment and Tax platforms, including cloud, hybrid, and on-premise components - Architect systems that are AI-consumable by design — APIs, data contracts, and schemas structured to serve as effective context for LLM-driven processes and agentic workflows - Lead DR/COB design, testing, and continuous improvement across critical payment infrastructure - Design and oversee data movement, ETL/ELT pipelines, and conversion strategies - Troubleshoot and resolve service-level, critical system, and architectural issues AI-First Development Leadership - Define and govern standards for AI-assisted development across engineering teams, including coding assistant usage, prompt engineering norms, and code review practices for AI-generated output - Evaluate, recommend, and operationalize AI developer tooling — including coding assistants (e.g., Claude, Cursor, Copilot), agent frameworks, and MCP (Model Context Protocol) integrations - Architect AI-augmented data access, reporting, and analytics patterns that enhance or replace traditional BI and ETL workflows - Design and oversee agentic or automated workflows within payment and tax processing pipelines - Partner with the CTO to define AI adoption metrics, measure productivity impact, and guide competitive positioning of the development team's AI capabilities Team Enablement & Collaboration - Provide architecture and domain guidance to development teams during user story breakdown and sprint planning - Coach, mentor, and train developers and architects on both technical and process dimensions, with emphasis on modern AI-assisted development practices - Translate complex business requirements from non-technical stakeholders into clear, high-level technical solution designs - Collaborate with data science, analytics, and IT infrastructure teams on cross-cutting technical and solution design - Instruct and align developers, architects, and teams on architecture decisions and standards Core Competencies - Cloud, hybrid, and on-premise infrastructure design and governance - Modern full-stack architecture — UI, application, data, and reporting layers - AI-native development practices: LLM tooling, agentic design, prompt-driven system architecture - Data engineering: ETL/ELT, data movement, conversion, and AI-augmented data access patterns - Agile software development methods, story breakdown, and cross-team coordination - Development environment design, CI/CD, and testing infrastructure - Stakeholder communication: translating business requirements into actionable technical designs - Technical coaching, mentoring, and architecture governance Qualifications & Experience Required - 7+ years of experience as an enterprise architect, application architect, or engineering product leader - Demonstrated experience designing and guiding implementation of multi-team development projects - Proven track record in agile software development environments - Experience with financial payment systems, including integration to bank systems, ACH/NACHA processing, or tax authorities - Experience with digital payments, payroll technology, or FinTech products - Hands-on experience with AI developer tools (e.g., Claude, Cursor, GitHub Copilot, or equivalent) and integrating them into team workflows — not just awareness, but actual daily use - Ability to define and enforce standards for AI-generated code quality, review practices, and responsible use Preferred - Experience with LLM APIs and prompt-based or agentic system design - Familiarity with MCP (Model Context Protocol) or similar agent-tool integration frameworks - Experience with RAG architectures, vector databases, or AI-augmented data retrieval - Exposure to AI adoption measurement, productivity benchmarking, or developer experience programs - Experience with HCM systems including Workday - Background in high-volume, compliance-driven payment processing environments #LI-REMOTE You are encouraged to learn and share ideas when you join the OneSource Virtual team. We reward innovative thinking, fresh perspectives, creative collaboration, and hard work. As an organization experiencing routine strategic growth, we are always on the lookout for intelligent, talented, and forward-thinking professionals to join our team. OSV employees enjoy a values-based culture, upward mobility, and professional development with opportunities of all kinds.

• Lead technology design and implementation across Payment and Tax product lines • Set architectural direction for a high-velocity engineering organization • Own enterprise architecture roadmap for Payment and Tax platforms • Architect AI-consumable systems designed for LLM-driven processes • Design and oversee data movement, ETL/ELT pipelines, and conversion strategies • Define and govern standards for AI-assisted development across engineering teams • Evaluate, recommend, and operationalize AI developer tooling • Coach, mentor, and train developers and architects on both technical and process dimensions

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. Job Description - Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. - Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. - What you will do - Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict adherence to policies and guidelines. - Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope. - Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. - Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims. - Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution. - Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims. - Determines if claims processing activities comply with regulatory requirements, industry standards, and company policies. - Develops and implements regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development. - Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Required Qualifications - Proficient in basic computer operations and software applications - Experience in a production environment. - Ability to key performance metrics including production, quality, and turnaround time. - Possess strong teamwork and organizational skills. Preferred Qualifications - Ability to multi-task - Ability to work independently or as part of a group Education High School diploma or equivalent GED Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $31.30 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.