Healthcare Compliance & Audit Specialist

BPI Burrell Preferred Inc.; Springfield (MO); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Employee Assistance Program

Mileage Reimbursement

Employee Discounts

Workplace Culture

Additional Perks & Benefits

Job summary

Brightli in Springfield, MO is seeking an Integrity Specialist, Market to uphold billing, coding, documentation, and regulatory compliance across behavioral and medical health services. You will conduct audits, identify improvement opportunities, and support organizational integrity while collaborating with leaders across departments.

The role requires strong analytical skills, attention to detail, ethics, and the ability to manage multiple priorities with confidentiality.

Qualifications

• Strong analytical, organizational, and problem-solving skills.
• Effective written, verbal, and interpersonal communication skills.
• Ability to work independently while managing multiple priorities and deadlines.
• Successful completion of background screenings including criminal, driving, abuse/neglect and fingerprint checks.

Responsibilities

• Conduct comprehensive audits and reviews of medical records, billing practices, coding accuracy, and clinical documentation to ensure compliance.
• 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.
• 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.

Skills

Analytical thinking

Organizational skills

Problem solving

Communication skills

Confidentiality

Independent work

Education

Associate's degree in Health Information Management, Medical Billing and Coding, Health Information Technology, or related field

RHIA

RHIT

CCS

CPC

COC

CPCA

Job description

Brightli in Springfield, MO is seeking an Integrity Specialist, Market to uphold billing, coding, documentation, and regulatory compliance across behavioral and medical health services. You will conduct audits, identify improvement opportunities, and support organizational integrity while collaborating with leaders across departments.

The role requires strong analytical skills, attention to detail, ethics, and the ability to manage multiple priorities with confidentiality.