Provider Payment Integrity Coordinator

Virginia Jobs

$78K — $95K *
Education, Government & Non-Profit
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in issue resolution and data analysis.
  • Ability to identify trends and recommend solutions in complex systems.
  • Experience synthesizing qualitative and quantitative data for decision making.
  • Strong background in process improvement and operational efficiency.
  • Proficiency in developing operational documentation and workflows.
  • Demonstrated relationship-building skills across various organizations.
  • Commitment to exceptional customer service principles.

Responsibilities

  • Investigate payment transactions and identify resolution paths.
  • Engage in trend analysis related to payment correction requests.
  • Collect and analyze data on provider inquiries for trend identification.
  • Recommend process improvements based on provider feedback.
  • Act as liaison between provider services and operational partners.
  • Collaborate with teams to prioritize and resolve system issues.
  • Strengthen training and resources based on inquiry trends.

Benefits

  • Opportunities for teleworking post-hire consideration.
  • Supportive work environment with emphasis on process improvement.
  • Potential for professional development resources.
  • Access to reasonable accommodations for applicants with disabilities.
Full Job Description
Title: Provider Payment Integrity Coordinator

State Role Title: Prog Admin Specialist II

Hiring Range: $78,000-$95,000

Pay Band: 5

Agency: Dept of Ed Central Operations

Location: JAMES MONROE BUILDING

Agency Website: doe.virginia.gov

Recruitment Type: General Public - G

Job Duties

The Virginia Department of Human Education (VDOE) is recruiting for a Provider Payment Integrity Coordinator to serve as the Office of Early Childhood Public-Private Provider Services' lead for researching, analyzing, and resolving complex Child Care Subsidy Program (CCSP) provider payment inquiries.

The position seeks to improve the provider payment experience and ensure program integrity by investigating potential payment errors, identifying root causes of payment issues, coordinating resolution across program, fiscal, and technology partners, and translating provider feedback into system, process, policy, and technical assistance improvements. Through data analysis, cross-functional collaboration, and continuous quality improvement, this position enhances provider supports, deepens the field's understanding of how payments are calculated and issued, strengthens payment accuracy, and informs statewide program improvements.

The Provider Payment Integrity Coordinator would be responsible for the following duties:

  • Review payment transactions, attendance records, provider accounts, banking information, and system data to determine root causes and coordinate timely resolution.
  • Support the PASS Correction Request process, including trend analysis and payment-related follow-up activities in partnership with the Subsidy Provider Services Manager.
  • Collect, analyze, and synthesize provider payment inquiry data to identify trends, recurring issues, systemic barriers, and opportunities for operational improvement.
  • Use provider feedback to recommend improvements to business processes, provider supports, system functionality, and payment operations.
  • Serve as a primary business liaison between Provider Services and internal and external partners responsible for payment operations and technology.
  • Coordinate with program, fiscal, policy, and technical teams to resolve system issues, prioritize enhancements, and improve provider payment processes.
  • Use provider feedback and inquiry trends to strengthen statewide technical assistance, written guidance, training materials, and knowledge resources related to subsidy payments.
  • Provide leadership for payment inquiry processes through documentation, standardization, knowledge sharing, and continuous process improvement.
  • Support consistent statewide practices without direct supervisory responsibility.

Minimum Qualifications

  • Demonstrated ability to research, interpret, and resolve complex issues using multiple information sources.
  • Demonstrated ability to identify trends, determine root causes, and recommend practical solutions.
  • Demonstrated ability to synthesize qualitative and quantitative information to inform decision making and continuous improvement.
  • Demonstrated ability to identify opportunities to improve business processes, customer experience, operational efficiency, and program effectiveness.
  • Demonstrated experience developing workflows, documentation, standard operating procedures, or business processes.
  • Proven ability to build collaborative relationships across organizational boundaries.
  • Demonstrated commitment to exceptional customer service.
  • Proficiency with Microsoft Office applications, especially Excel (or other data analysis software).
  • Demonstrated ability to collect, organize, analyze, and present data.
  • Demonstrated ability to learn multiple data systems and technology platforms.

Additional Considerations

  • Experience in a customer-service or customer-facing role and/or case management.
  • Experience working with child care providers or other human service partners.
  • Experience interpreting policy or program guidance.
  • Experience using data to improve business processes or customer experience.
  • Experience developing training materials, guidance documents, or technical assistance resources.
  • Spanish language proficiency

Special Instructions

You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to "Your Application" in your account to check the status of your application for this position.

A résumé will be accepted in lieu of a completed state application. Applications submitted via e-mail, postal service, fax or hand-delivered will not be considered. Successful candidates must pass a criminal background check. Commonwealth of Virginia employees may have teleworking options available. Final teleworking agreements will be reviewed and approved upon hire.

This role will require completion of a Statement of Economic Interests (SOEI), which is filed annual with the General Assembly.

Reasonable accommodations are available to persons with disabilities during the application and/or interview process. For assistance call: [redacted], [TTY: [redacted]]

Contact Information

Name: Human Resources



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