Healthcare Compliance Auditor — Billing & Coding

Centerstone; Springfield (MO); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Employee Assistance Program

Mileage Reimbursement

Employee Discounts

Workplace Culture

Top-notch training

Career mobility

Welcoming environment

Job summary

Brightli is seeking an Integrity Specialist, Market in Springfield, MO, to safeguard billing accuracy, coding integrity, and regulatory compliance across behavioral and medical health services. You'll conduct audits, identify improvement opportunities, and collaborate with leaders across departments to strengthen our compliance program.

This role requires a detail-oriented professional with analytical skills, strong communication, and a commitment to ethical practices.

Qualifications

• Associate's degree in Health Information Management, Medical Billing and Coding, Health Information Technology, or related field.
• RHIA, RHIT, CCS, CPC, COC, or CPCA certification required. If not 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.

Responsibilities

• Conduct comprehensive audits 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.

Skills

Analytical

Organizational

Problem Solving

Communication

Confidentiality

Education

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

RHIA, RHIT, CCS, CPC, COC, or CPCA certification

Job description

Brightli is seeking an Integrity Specialist, Market in Springfield, MO, to safeguard billing accuracy, coding integrity, and regulatory compliance across behavioral and medical health services. You'll conduct audits, identify improvement opportunities, and collaborate with leaders across departments to strengthen our compliance program.

This role requires a detail-oriented professional with analytical skills, strong communication, and a commitment to ethical practices.