Payment Integrity Data Analytics Specialist

PacificSource; North Bend (OR); On-site; USD 57,000 - 97,000; Full time

Job summary

PacificSource is seeking a Payment Integrity Analytics Specialist in Oregon to analyze claims data, develop dashboards, and monitor performance metrics to improve payment integrity, fraud, waste and abuse detection.

You will collaborate with Finance, Compliance, Claims Operations, IT, and external vendors to produce actionable insights, support budgeting and regulatory reporting, and present findings to leadership.

A minimum of 3 years in healthcare analytics or related fields is required.

Qualifications

• Minimum 3 years of healthcare analytics, claims analytics, payment integrity, finance analytics, reimbursement analysis, or closely related experience.
• Knowledge of healthcare claims processing and reimbursement methodologies.
• Experience with data analysis and reporting tools such as SQL, Power BI, or Tableau.

Responsibilities

• Develop and maintain payment integrity dashboards, reports, and performance scorecards.
• Track recoveries, cost avoidance, savings, and operational performance metrics.
• Analyze claims, provider, reimbursement, and audit data to identify payment integrity opportunities.
• Support fraud, waste, and abuse detection through data analysis and reporting.
• Create ad hoc analyses and presentations to support leadership decision-making.

Skills

Healthcare analytics

Data analysis

SQL

Power BI

Tableau

Excel

Reimbursement analysis

Reporting

Education

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

High school diploma or equivalent

Tools

Power BI

Tableau

Excel

Job description

PacificSource is seeking a Payment Integrity Analytics Specialist in Oregon to analyze claims data, develop dashboards, and monitor performance metrics to improve payment integrity, fraud, waste and abuse detection.

You will collaborate with Finance, Compliance, Claims Operations, IT, and external vendors to produce actionable insights, support budgeting and regulatory reporting, and present findings to leadership.

A minimum of 3 years in healthcare analytics or related fields is required.