Integrity Specialist, Market

Brightli • Springfield, MO

1d • Onsite

About The Position

Are you passionate about accuracy, compliance, and making a meaningful impact in healthcare? Join our compassionate and collaborative team as an Integrity Specialist, Market, where your expertise will help ensure the highest standards of billing, coding, documentation, and regulatory compliance across behavioral and medical health services. In this role, you'll have the opportunity to conduct meaningful audits, identify opportunities for improvement, support organizational integrity, collaborate with leaders across multiple departments, and contribute directly to quality healthcare services that improve lives. We are seeking a detail-oriented professional with strong analytical abilities, excellent communication skills, a commitment to ethical practices, and a passion for continuous improvement.
The Integrity Specialist supports the Compliance program through auditing, monitoring, and investigating billing, coding, documentation, reimbursement, and compliance-related activities. This position works closely with compliance leadership, clinical teams, and operational staff to identify areas of risk, ensure adherence to healthcare regulations, support corrective action initiatives, and promote compliant practices throughout the organization. The role requires sound judgment, attention to detail, and the ability to manage multiple priorities while maintaining confidentiality and professionalism.

Requirements

• Associate's degree in Health Information Management, Medical Billing and Coding, Health Information Technology, or a related field.
• RHIA, RHIT, CCS, CPC, COC, or CPCA certification required. If not currently credentialed, must attain an approved credential within six months of assuming the position.
• Knowledge of federal and state healthcare reimbursement requirements.
• Working knowledge of ICD-10, CPT, and HCPCS coding guidelines.
• Strong analytical, organizational, and problem-solving skills.
• Ability to interpret healthcare regulations, organizational policies, and medical documentation.
• Effective written, verbal, and interpersonal communication skills.
• Ability to work independently while successfully managing multiple priorities and deadlines.
• Ability to maintain strict confidentiality in a fast-paced environment.
• Successful completion of background screenings, including criminal record, driving record, abuse/neglect, and fingerprint checks.
• Current driver's license, acceptable driving record, and current automobile insurance required.

Nice To Haves

• One to three years of experience in healthcare compliance, auditing, coding, billing, or a related field preferred.
• Behavioral health experience preferred.

Responsibilities

• Conduct comprehensive audits and reviews of medical records, billing practices, coding accuracy, and clinical documentation to ensure compliance and service integrity.
• Investigate potential overpayments, billing concerns, and compliance risks identified through audits, monitoring activities, or internal disclosures.
• Develop and maintain audit work plans, tools, and methodologies that address prioritized compliance risks.
• Identify, quantify, and monitor overpayments while ensuring accurate documentation and timely repayment activities.
• Prepare detailed audit reports outlining findings, recommendations, risk assessments, and corrective action opportunities.
• Collaborate with compliance leadership, privacy officers, clinical teams, and operational stakeholders to resolve identified issues.
• Support the development and enhancement of policies, procedures, and corrective action plans related to billing and documentation compliance.
• Provide compliance education, training, and guidance based on audit findings and emerging risk trends.
• Prepare and present audit summaries, trends, and recommendations to compliance leadership and market stakeholders.
• Coordinate and manage documentation requests for external billing reviews and audits.
• Perform additional compliance-related responsibilities as assigned.

Benefits

• Employee Assistance Program – 24/7 counseling services, legal assistance, & financial consultation for you and your household at no cost
• Mileage Reimbursement – Company paid for work functions requiring travel
• Employee Discounts – Hotels, Theme Parks & Attractions, College Tuition
• Paid time off: full-time employees receive an attractive time off package to balance your work and personal life
• Employee benefits package: full-time employees receive health, dental, vision, retirement, life, & more
• Top-notch training: initial, ongoing, comprehensive, and supportive
• Career mobility: advancement opportunities/promoting from within

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree