Payment Integrity Program Specialist

$56.78k - $96.53k

Full-time

PacificSource

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
Adaptability
Building Customer Loyalty
Building Strategic Work Relationships
Building Trust
Continuous Improvement
Contributing to Team Success
Planning and Organizing
Work 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.

Apply

Vacancy posted 4 hours ago

Similar jobs that could be interesting for youBased on the Payment Integrity Program Specialist in Springfield, OR vacancy

FEMA - Program Delivery Specialist
$128.06 per hour
...and change the world. Job Description ~ The Disaster Program Delivery Specialist: • Collects, coordinates and/or reviews applicant data to... ...from the CDM Smith Talent Acquisition Manager to receive payment for your placement. Verbal or written commitments from any...
Suggested
Work experience placement
H1b
Immediate start
Flexible hours
CDM Smith
Eugene, OR
5 days ago
Electrocardiogram (ECG / EKG) Technician - Entry Level Training Program - Eugene
...Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you... ...Flexible hybrid and in-person options available • Affordable payment plans Cost : This program is an educational opportunity...
Suggested
Flexible hours
Dreambound
Eugene, OR
16 days ago
Peer Wellness Specialist
$22.7 per hour
...looking for a compassionate Peer Wellness Specialist to work in ShelterCare's Medical Respite... ...is responsible for supporting the program participants of the ShelterCare Medical... ...based activities; agility and flexibility; integrity and care; a commitment to diversity, equity...
Suggested
Hourly pay
Monday to Friday
ShelterCare
Eugene, OR
21 days ago
Mental Health Group Specialist
...high-impact group facilitation. As a Mental Health Group Specialist, you will begin making a difference on day one, working alongside... ...times and facilitate across various age groups and cohorts (Integrative, Support Staffing, and Wellness Hour). Engagement: Foster...
Suggested
Full time
Part time
Local area
Remote work
Monday to Friday
Charlie Health
Eugene, OR
3 days ago
Meter Relay Technician or Trainee
$70 per hour
...Traineemust complete EWEB-approved three-year meter relay training program toattainjourney status. Please note: Applicants mustbe... ...psychological wellness of our workforce and the public the security and integrity of cyber assets and data and the protection of our customers...
Suggested
Full time
For contractors
Apprenticeship
Traineeship
Internship
Local area
Work from home
Eugene Water and Electric Board
Eugene, OR
7 days ago
Trailer/SRI Repair Specialist
...also be able to continue to grow through our Technician Training Program, including using classes from Ford, GM and U-Haul itself. U-... ...and our family atmosphere.As a U-Haul trailer and SRI repair specialist, you will use U-Haul Company’s proprietary technology to assess...
Full time
Start working today
Local area
U-Haul
Eugene, OR
2 days ago
Energy and Power Discipline Leader
$248.39k
...to design and implement electrification integration into changing grid operations and landscapes... ..., planning for operations, advising on program development, design, and implementation,... ...Talent Acquisition Manager to receive payment for your placement. Verbal or written...
Work experience placement
H1b
Local area
CDM Smith
Eugene, OR
1 day ago
Trailer/SRI Repair Specialist
...Oregon 97403 United States of America Trailer and SRI Repair Specialist Ready to rev up your career? U-Haul is looking for skilled... ...be able to continue to grow through our Technician Training Program, including using classes from Ford, GM and U-Haul itself. U-Haul...
Full time
Start working today
Local area
U-Haul
Eugene, OR
4 days ago
Forward Deployed Specialist, Physical AI
$126k - $158k
...deploy solutions at scale using its global integration and distributions capabilities. With... ...Job Summary The Forward Deployed Specialist is the builder on the ground for WWT's... ...Centers (MO & IL), Employee Assistance Program, Wellness program Financial Benefits...
Full time
Flexible hours
Shift work
World Wide Technology
Eugene, OR
4 days ago
Housing Specialist
$24.11 - $32.33 per hour
...Homes for Good is searching for a Housing Specialist to join our team! Homes for Good Housing Agency is a high performing public housing... ..., Office Assistants, a Landlord Liaison, Data Analyst, Program Supervisor and Division Director. We believe that safe and affordable...
Hourly pay
Work at office
Homes for Good
Eugene, OR
5 days ago
Construction Specialist 3
$136.24k
...personnel and vendors. Develops or assists in the development of purchase orders, subcontracts, change orders, and applications for payment to the client. Develops simple to complex scopes of work. Performs surveying functions and verifies final locations and...
Contract work
Work experience placement
For subcontractor
H1b
CDM Smith
Eugene, OR
3 days ago
Receiving Specialist
$15.8 - $18 per hour
...Description What to expect when you work here As a Receiving Specialist, you will be responsible for managing the store's backroom... ...safety, and wellness of our employees seriously. Our Wellness program and safety committee offer workshops, classes, resources, etc....
Hourly pay
Part time
Immediate start
Shift work
Night shift
Afternoon shift
Comoto
Springfield, OR
5 days ago
Delivery Specialist
...Delivery Specialist The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional... ...Spending Account (FSA) Team Member Health/Wellbeing Programs Tuition Educational Assistance Programs Opportunities for...
Local area
Immediate start
Remote work
Flexible hours
O'Reilly Auto Parts
Springfield, OR
1 day ago
Parts Specialist
...The Parts Specialist will provide all retail and installer customers with a high level of service. This position will also support store... ...FUNCTIONS Follow and promote all company customer service programs, i.e. Hi-5, Low Price Guarantee, Rock the Call, Related Selling...
Local area
Flexible hours
O'Reilly Auto Parts
Springfield, OR
1 day ago
Bilingual Parts Delivery Specialist
...O'Reilly Auto Parts is seeking a Delivery Specialist to maintain and operate store vehicles, delivering parts to professional customers safely and efficiently. This role also handles COD payments and returns pickups. Responsibilities include using fleet devices, processing...
O'Reilly Auto Parts
Springfield, OR
1 day ago
Verification Specialist
...for over 30 years. We're looking for a Verification Specialist to join us at our award-winning, people-first company. If you... ...within the company. We're proud of our popular staff incentive program, where you can earn points for everyday successes. Cash in...
Work at office
Local area
Shift work
New Horizons
Eugene, OR
4 days ago
Program Leader - Youth Programs
...Job Description Job Description PROGRAM LEADER - YOUTH PROGRAMS Part-time, Non-exempt, non-benefitted position Training and Programs to begin 9/3/26 APPLICATION CLOSING DATE: Open to Willamalane employees only through 5PM on August 3, 2026 Open until...
Part time
Summer work
Immediate start
Monday to Friday
Shift work
Willamalane Park and Recreation District
Springfield, OR
a month ago
Technical Solutions Architect I -- Computer Vision Specialist
$110k - $138k
...deploy solutions at scale using its global integration and distribution capabilities. With... ...you be doing? The Computer Vision Specialist is a member of WWT’s Global Solutions &... ...Centers (MO & IL), Employee Assistance Program, Wellness program Financial Benefits...
Full time
Work experience placement
Remote work
Flexible hours
Shift work
World Wide Technology
Eugene, OR
2 days ago
Tree and Shrub Specialist
...as product suggestions. This position is for a Tree and Shrub Specialist. The ideal candidate should be a friendly, motivated, and people... ...clients. Be fully familiar with all of Gray’s policies, programs, and events schedules. Work with guests in selecting Local...
Full time
Seasonal work
Local area
Weekend work
Gray's Garden Center
Eugene, OR
20 days ago
Checkout Team Associate
...They smile, greet and thank customers, ring up items, process payments, and keep a positive attitude. Always ready to help with customer... ...PTO, see . Live Better U is a Walmart-paid education benefit program for full-time and part-time associates in Walmart and Sam's Club...
Hourly pay
Minimum wage
Full time
Temporary work
Part time
Shift work
Weekend work
Afternoon shift
Walmart
Eugene, OR
2 days ago
Delivery Specialist
The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and... ...Flexible Spending Account (FSA) Team Member Health/Wellbeing Programs Tuition Educational Assistance Programs Opportunities for...
Local area
Immediate start
Flexible hours
O'Reilly Auto Parts
Springfield, OR
1 day ago
Construction Inspection Specialist (Flex Staff)
$63 per hour
...Disclaimer All vendors must have a signed CDM Smith Placement Agreement from the CDM Smith Talent Acquisition Manager to receive payment for your placement. Verbal or written commitments from any other member of the CDM Smith Inc. and its divisions and subsidiaries...
Contract work
For contractors
Work experience placement
H1b
Immediate start
Overseas
Flexible hours
CDM Smith
Eugene, OR
5 days ago
Parts Specialist
Job Summary The Parts Specialist will provide all retail and installer customers with a high level of service, support store management... ...Job Functions Follow and promote all company customer service programs, e.g., Hi-5, Low Price Guarantee, Rock the Call, Related Selling...
Local area
Flexible hours
O'REILLYAUTO
Eugene, OR
3 days ago
Senior Analyst - Oracle Procure to Pay (P2P)
$96.4k - $144.6k
...of Oracle Accounts Payables and Oracle Payments, including invoice lifecycle, matching,... ...rules, approval routing, and corporate card programs. Working knowledge of the upstream... ...information management, or the Coupa-to-Oracle integration — is a strong bonus. Exposure to tax...
Full time
Remote work
Flexible hours
Shift work
World Wide Technology
Eugene, OR
4 days ago
Leasing Associate
...live. What We Do Founded in 2010, Core is a vertically integrated real estate investment manager focused on acquiring, developing... ...you a voice to share your perspectives Employee Assistance Program (EAP) for access to confidential support services Company retirement...
Full time
Work at office
Flexible hours
Shift work
Afternoon shift
Core Spaces
Eugene, OR
3 days ago
Assistant Community Manager The Tennyson at Crescent Village
$24 - $26 per hour
...GREYSTAR Greystar is a leading fully integrated global real estate platform offering expertise... ...reports processing invoices for payment collecting rent fees and other payments... ...to date on rent assistance policies and programs from federal state and local governing offices...
Hourly pay
Full time
For contractors
Local area
Immediate start
Greystar Management Services
Eugene, OR
1 day ago
Contact Center Specialist
$18.7 - $21.25 per hour
...member transactions, including but not limited to withdrawals, loan payments, wire transfers, and money transfers, while maintaining up-to... ...and security by following the Member Identification Program (MIP) and other established security procedures, including fraud...
Hourly pay
16 hours
Full time
Local area
Remote work
Monday to Friday
Peak Credit Union
Eugene, OR
8 days ago
COMMUNITY MANAGER
$2,200 per month
...Oregon and Washington. As a team, we accomplish objectives through integrity, leadership, communication, trust, loyalty, quality, and... ...to ensure that they are aware of vacancies and any promotional program being offered to attract new tenants. Maintain and update Facility...
Part time
Work at office
Local area
Commonwealth
Eugene, OR
15 days ago
Asset Protection Specialist
...SpecialistPosition Purpose:The Asset Protection Specialist is primarily responsible for preventing... ...and supporting safety and environmental program compliance in their assigned store/... ...and the Company. They must demonstrate integrity at all times, respond to asset...
Home Depot (Retail)
Eugene, OR
2 days ago
Leader In Training (Full-Time)
...knowledge of current sales and promotions, policies regarding payment and exchanges, and security practices Remain consistent on personal... ...Plan Performance Bonuses Leave Options Employee Assistance Program Education and/or Experience High school diploma or general education...
Hourly pay
Full time
Work at office
Local area
All shifts
Flexible hours
Shift work
Day shift
Afternoon shift
Buckle LLC
Eugene, OR
4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Payment Integrity Program Specialist. Be the first to apply!