Payment Integrity Data & Insights Specialist

PacificSource; Boise (ID); Hybrid; USD 57,000 - 97,000; Full time

Benefits offered by this job

Flexible telecommute policy

Competitive wages and benefits

Job summary

PacificSource in Boise, Idaho is seeking a healthcare analytics professional to lead payment integrity analytics, reporting, and performance scorecards, leveraging SQL, Power BI, Tableau, and Excel to improve reimbursements and identify opportunities.

You will partner with IT and enterprise data teams, analyze claims and audits, support budgeting and regulatory reporting, and deliver ad hoc analyses to leadership.

Qualifications

• Healthcare analytics data and reporting experience required.
• Knowledge of claims processing and reimbursement methodologies.
• Familiarity with SQL, Power BI, Tableau or similar tools.

Responsibilities

• Develop, maintain, and distribute payment integrity dashboards and scorecards.
• Track recoveries, cost avoidance, savings, and performance metrics.
• Analyze claims, provider and audit data to identify opportunities and trends.
• Support fraud, waste, and abuse detection through data analysis.
• Monitor vendor performance and validate reported recoveries and metrics.
• Create recurring operational, financial, and executive reports.

Skills

Healthcare analytics

Data analysis

SQL

Power BI

Tableau

Excel

Education

Bachelor's degree in related field

High school diploma or equivalent

Tools

SQL

Power BI

Tableau

Excel

Job description

PacificSource in Boise, Idaho is seeking a healthcare analytics professional to lead payment integrity analytics, reporting, and performance scorecards, leveraging SQL, Power BI, Tableau, and Excel to improve reimbursements and identify opportunities.

You will partner with IT and enterprise data teams, analyze claims and audits, support budgeting and regulatory reporting, and deliver ad hoc analyses to leadership.