Remote Payment Integrity Analytics Specialist

PacificSource; Georgia; Hybrid; USD 57,000 - 97,000; Full time

Benefits offered by this job

Flexible telecommute policy

Medical, vision, and dental insurance

401(k) plan

Tuition reimbursement and training

Job summary

PacificSource is seeking a data analytics professional to develop and maintain payment integrity dashboards, reports, and scorecards across healthcare programs. You will analyze claims data to identify opportunities and support leadership with timely, data-driven insights.

The role emphasizes collaboration with IT and data teams, compliance with HIPAA, and contributing to budgeting and forecasting for payment integrity programs.

Qualifications

• Minimum of 3 years of healthcare analytics, claims analytics, payment integrity, or related experience.
• Bachelor's degree preferred in business, finance, statistics, data analytics, or healthcare administration.
• Strong data analysis, reporting, and MS Excel skills; familiarity with HIPAA.”],
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Responsibilities

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

Skills

Accountability

Collaboration

Communication

Flexibility

Active Listening

Organization & Planning

Problem Solving

Teamwork

SQL

Power BI

Tableau

Education

Bachelor's degree in business/finance/data analytics/healthcare administration

High school diploma or equivalent

Tools

SQL

Power BI

Tableau

Job description

PacificSource is seeking a data analytics professional to develop and maintain payment integrity dashboards, reports, and scorecards across healthcare programs. You will analyze claims data to identify opportunities and support leadership with timely, data-driven insights.

The role emphasizes collaboration with IT and data teams, compliance with HIPAA, and contributing to budgeting and forecasting for payment integrity programs.