Integrity Specialist, Market

Job Description:

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 over payments, 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 over payments 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…