Integrity Specialist, Market

Integrity Specialist

Job Title: Integrity Specialist, Market Location: Springfield, Missouri Department: Compliance and Integrity Employment Type: Full-Time

Job Summary:

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.

This position offers:

• 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
• Workplace Culture An environment cultivating employee wellbeing, valuing each individual's humanity, and actively promoting a healthy, joyful workforce
• Additional Perks & Benefits Scroll down to bottom of this post to learn more

Key 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.

Education, Experience, and/or Credential Qualifications:

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.

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

Knowledge of federal and state healthcare reimbursement requirements.

Working knowledge of ICD-10, CPT, and HCPCS coding guidelines.

Behavioral health experience preferred.

Additional Qualifications:

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.

Physical Requirements:

Perform sedentary work requiring exertion of up to 10 pounds of force occasionally and negligible force frequently to lift, carry, push, pull, or move objects.

Sit for extended periods throughout the workday with occasional walking and standing.

Perform repetitive hand, finger, and arm movements for typing, data entry, and written documentation.

Maintain visual focus and attention to detail while reviewing records, reports, and electronic documentation.

Keywords: Integrity Specialist, Compliance, Healthcare Compliance, Medical Auditing, Billing Compliance, Medical Coding, ICD-10, CPT Coding, Health Information Management, Behavioral Health Careers

Position Perks & Benefits:

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

Welcoming, warm, supportive: a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness

Brightli is on a Mission:

A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance user care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.

As a behavioral and community mental health provider, we prioritize fostering a culture of belonging and connection within our workforce. We encourage applications from individuals with varied backgrounds and experiences, as we believe that a rich tapestry of perspectives strengthens our mission. If you are passionate about empowering local communities and creating an environment where everyone feels valued and supported, we invite you to join our mission-driven organization dedicated to cultivating an authentic workplace.

We are an Equal Employment Opportunity Employer.

Brightli is a Smoke and Tobacco Free Workplace.