Healthcare Payment Integrity Analytics Pro

pacificsource; Springfield (OR); On-site; USD 57,000 - 97,000; Full time

Job summary

PacificSource is seeking an experienced healthcare analytics professional to develop and maintain payment integrity dashboards, reports, and scorecards. You will analyze claims data, monitor recoveries, and support fraud detection while partnering with IT and data teams to enhance reporting capabilities.

Ideal candidates have 3+ years in healthcare analytics or related fields, a bachelor's degree in a related area, and strong skills in SQL, Power BI, and Excel.

Qualifications

• Minimum 3 years of healthcare analytics, claims analytics, payment integrity, finance analytics, reimbursement analysis, or closely related experience.
• Bachelor's degree preferred; high school diploma or equivalent required.

Responsibilities

• Develop, maintain, and distribute payment integrity dashboards, reports, and performance scorecards.
• Track and monitor recoveries, cost avoidance, savings, inventory, and operational performance metrics.
• Analyze claims, provider, reimbursement, and audit data to identify payment integrity opportunities and emerging trends.
• Support fraud, waste, and abuse detection efforts through data analysis and reporting.
• Monitor vendor performance and validate reported recoveries, savings, and contractual performance measures.
• Develop recurring operational, financial, and executive reporting.
• Perform data validation, reconciliation, and quality assurance activities.
• Support audit targeting, provider outlier analysis, and recovery opportunity identification.
• Create ad hoc analyses and presentations to support leadership decision-making.
• Partner with Information Technology and enterprise data teams to improve reporting capabilities and data accessibility.
• Identify trends, risks, and opportunities and provide data-driven recommendations to leadership.
• Assist with budgeting, forecasting, and performance measurement activities related to payment integrity programs.
• Support regulatory reporting, audits, and documentation requests.
• Participate in departmental meetings and assigned projects.

Skills

Accountability

Collaboration

Communication

Flexibility

Listening

Organizational skills

Planning and Organization

Problem Solving

Teamwork

Education

Bachelor's degree in business, finance, statistics, data analytics, healthcare administration, information systems, or related field

High school diploma or equivalent

Tools

SQL

Power BI

Tableau

Excel

Job description

PacificSource is seeking an experienced healthcare analytics professional to develop and maintain payment integrity dashboards, reports, and scorecards. You will analyze claims data, monitor recoveries, and support fraud detection while partnering with IT and data teams to enhance reporting capabilities.

Ideal candidates have 3+ years in healthcare analytics or related fields, a bachelor's degree in a related area, and strong skills in SQL, Power BI, and Excel.