Payment Integrity Analytics Specialist

PACIFICSOURCE

. Develop, maintain, and distribute payment integrity dashboards, reports, and performance scorecards .

Posted 10/6/2026full-timeRemote • Missouri • United StatesMid-LevelSenior💰 $56,780 - $96,526 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare analytics, claims analytics, and payment integrity, with a strong focus on data analysis, reporting, and performance measurement. Proficient in identifying trends and providing data-driven recommendations while ensuring compliance with regulatory standards.

Highest-signal resume keywords

Healthcare AnalyticsClaims AnalyticsPayment IntegrityData AnalysisMicrosoft Excel

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data ValidationReconciliationQuality AssuranceStatistical AnalysisPerformance MeasurementReporting TechniquesBudgetingForecastingOperational Performance MetricsFraud Detection

Soft Skills

Clear CommunicationEffective Collaboration

Tools & Technologies

Reporting ToolsData Analytics Software

Industry Keywords

Healthcare Claims ProcessingReimbursement MethodologiesHIPAA ComplianceOperational InitiativesPerformance Scorecards

About the role

Key responsibilities & impact

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
Participate in compliance and operational initiatives as needed
Meet department and company performance and attendance expectations
Perform other duties as assigned

Requirements

What you’ll need

Minimum of 3 years of healthcare analytics, claims analytics, payment integrity, finance analytics, reimbursement analysis, or closely related experience required
High school diploma or equivalent required
Bachelor's degree in business, finance, statistics, data analytics, healthcare administration, information systems, or related field preferred
Knowledge of healthcare claims processing and reimbursement methodologies
Knowledge of data analysis and reporting techniques
Knowledge of Microsoft Excel and reporting tools
Knowledge of statistical analysis and performance measurement concepts
Ability to read and comprehend both written and spoken English
Ability to communicate clearly and effectively
Ability to comply with PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information
Ability to work inside in a general office setting with ergonomically configured equipment
Travel required approximately 5% of the time