Payment Integrity Program Specialist

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

Job summary

PacificSource is seeking a Payment Integrity Program Specialist in Springfield, OR to coordinate with external vendors and internal partners, support new initiatives, and monitor program performance. You will manage documentation, reporting, and regulatory support to improve payment integrity outcomes.

The role requires at least 3 years in healthcare operations or related areas and a Bachelor’s degree is preferred.

Qualifications

• Minimum of 3 years of healthcare operations, project coordination, vendor management, claims administration, or payment integrity experience.
• Bachelor's degree preferred; high school diploma required.

Responsibilities

• Coordinate day-to-day activities with external payment integrity vendors and business partners.
• Support implementation of new payment integrity initiatives, audit programs, recovery projects, and operational enhancements.
• Track vendor performance metrics, SLAs, recoveries, savings, and milestones.
• Maintain payment integrity inventories, project plans, work logs, and tracking tools.
• Schedule internal/external meetings; document action items and follow-up.
• Prepare reports and presentations for leadership and committees.
• Support regulatory reporting and audit documentation.
• Maintain policies, procedures, workflows and program documentation.
• Facilitate cross-functional communication among teams and vendors.
• Assist with testing, readiness activities, and post-implementation monitoring.
• Contribute to process improvement projects and risk tracking.
• Monitor risks/issues; escalate to leadership as needed.
• Track recoveries and cost avoidance; report on performance metrics.
• Join department meetings and represent Payment Integrity on projects.
• Assist with contract and vendor performance document management.

Skills

Healthcare operations

Project coordination

Vendor management

Claims administration

Payment integrity

Documentation

Communication

Attention to detail

Education

Bachelor's degree preferred

Tools

Microsoft Excel

PowerPoint

Job description

## Payment Integrity Program SpecialistApply: Springfield, OR: Full time: Posted Today: 2026-1243# **Looking for a way to make an impact and help people?***Join PacificSource and help our members access quality, affordable care!***PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age.** PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.The Payment Integrity Program Specialist supports the administration, coordination, and continuous improvement of PacificSource's Payment Integrity program. This role serves as a key operational resource responsible for vendor coordination, implementation support, project tracking, savings monitoring, reporting coordination, documentation management, project coordination, and cross-functional communication. The Program Specialist works closely with Payment Integrity leadership, Claims, Finance, Compliance, Provider Relations, and external vendors to support program effectiveness and successful execution of payment integrity initiatives.
**Essential Responsibilities:*** Coordinate day-to-day activities with external payment integrity vendors and business partners.* Coordinate and support implementation of new payment integrity initiatives, audit programs, recovery projects, and operational enhancements.* Track and monitor vendor performance metrics, service level agreements, recoveries, savings, and project milestones.* Assist with maintenance of payment integrity inventories, project plans, work logs, and tracking tools.* Coordinate internal and external meetings, document action items, and monitor follow-up activities.* Prepare reports, presentations, and supporting documentation for leadership, committees, and business partners.* Support regulatory reporting, audit requests, and documentation requirements.* Maintain payment integrity policies, procedures, workflows, and program documentation.* Facilitate communication between Payment Integrity, Claims, Finance, Compliance, Provider Relations, Information Technology, and external vendors.* Assist with implementation testing, operational readiness activities, and post-implementation monitoring.* Support process improvement initiatives and departmental projects.* Monitor project risks, issues, and dependencies and escalate concerns to leadership as appropriate.* Assist with tracking recoveries, cost avoidance activities, vendor savings, and operational performance metrics.* Participate in departmental meetings and represent Payment Integrity on assigned projects and workgroups.* Assist with contract, statement of work, and vendor performance document management.**Supporting Responsibilities:*** Meet department and company performance and attendance expectations.* Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.* Perform other duties as assigned.**SUCCESS PROFILE****Work Experience:** Minimum of 3 years of healthcare operations, project coordination, vendor management, claims administration, payment integrity, or closely related experience required.**Education, Certificates, Licenses:** Bachelor's degree preferred. High school diploma or equivalent required**Knowledge:** Healthcare operations and claims administration. Project coordination and implementation support. Vendor management and performance monitoring. Reporting and documentation management. Microsoft Excel, PowerPoint, and other business productivity tools. Healthcare reimbursement and payment integrity concepts preferred.**Competencies**AdaptabilityBuilding Customer LoyaltyBuilding Strategic Work RelationshipsBuilding TrustContinuous ImprovementContributing to Team SuccessPlanning and OrganizingWork Standards**Environment:** Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.**Skills:**Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork**Compensation Disclaimer**The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.**Base Range:**$56,779.86 - $96,525.75# **Our Values**We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:* We are committed to doing the right thing.* We are one team working toward a common goal.* We are each responsible for customer service.* We practice open communication at all levels of the company to foster individual, team and company growth.* We actively participate in efforts to improve our many communities-internally and externally.* We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.* We encourage creativity, innovation, and the pursuit of excellence.**Physical Requirements:** Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.**Disclaimer:** This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.