Job Description:

Job Title: Compliance Partner 

Location: Springfield, Missouri 

Department: Compliance and Integrity 

Employment Type: Full-time 

Job Summary: 
Join our dedicated team as a Compliance Partner, where you will play a crucial role in ensuring adherence to compliance policies across our regions and service lines.   This role supports day-to-day compliance functions, including the development and delivery of compliance training, conducting investigations, analyzing compliance data, ensuring regulatory conformance, and monitoring corrective action plans. This role places a strong emphasis on medical billing accuracy, healthcare claims auditing, and regulatory documentation compliance. 

The Compliance Partner is responsible for the effective implementation and coordination of compliance policies within assigned regions or service lines, serving as the primary resource for corporate compliance matters. This position promotes a culture of integrity, regulatory accountability, and continuous improvement in healthcare compliance. 

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 

Essential Job Functions:  

Compliance Program Management 

Implement and monitor regional compliance activities in alignment with federal, state, and accreditation standards (e.g., CMS, OIG, CARF, HIPAA, 42 CFR Part 2). 

Identify risk trends, monitor for policy non-conformance, and develop mitigation strategies in collaboration with leadership. 

Participate in development and review of policies, procedures, and compliance initiatives across service lines. 

Compliance Training & Education 

Develop and coordinate corporate compliance training tailored to high-risk roles, including billing, coding, and clinical documentation. 

Track training metrics, ensure annual attestations, and assist team members in understanding the Code of Conduct and non-retaliation policies. 

Educate team members on compliance with hotline use and mandatory reporting obligations. 

Investigations & Auditing 

Conduct investigations of compliance concerns, including billing errors, coding discrepancies, and potential fraud, waste, or abuse. 

Prepare detailed, objective investigative reports citing applicable regulatory guidance. 

Lead and/or support focused internal audits of claims and documentation for billing integrity. 

Medical Claims Monitoring 

Perform regular review of clinical documentation, encounter notes, and medical claims for accuracy, coding compliance (CPT, HCPCS, ICD-10), and timeliness. 

Coordinate with billing teams, clinical providers, and coders to correct and prevent future errors. 

Provide feedback, identify trends, and make recommendations for improved billing practices. 

Collaboration & Reporting 

Partner with HR and leadership on disciplinary action, training compliance, and mitigation follow-through. 

Regularly report findings, outcomes, and metrics to the Vice President of Compliance Culture. 

Attend team meetings, team member events, and engage with employees across locations to support compliance visibility and awareness. 

Other duties as assigned. 

Knowledge, Skills, and Abilities: 

Extensive knowledge of healthcare regulations, coding, and billing standards (CMS, Medicaid, CARF, HIPAA, 42 CFR Part 2). 

Strong understanding of clinical documentation integrity and audit standards. 

Exceptional verbal and written communication skills. 

Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) and Electronic Health Record (EHR) systems. 

Strong analytical, problem-solving, and investigative skills. 

Ability to manage multiple priorities, meet deadlines, and maintain confidentiality. 

Ability to travel to various locations, including occasional overnight travel. 

Experience and Education Qualifications: 

Bachelor’s degree in health administration, nursing, health information management, or a related field required. 

Three years of experience auditing medical claims, billing processes, or health plan compliance required. 

Medical coding certification preferred such as one or more of the following: 

Certified Professional Coder (CPC) – AAPC 

Certified Coding Specialist (CCS) – AHIMA 

Certified Professional Medical Auditor (CPMA) – AAPC (preferred) 

Licensed Practical Nurse (LPN) preferred for BMG billing processes. 

Experience with compliance investigations and/or healthcare compliance program implementation strongly preferred. 

Experience in behavioral health or substance use disorder services is a plus. 

Supervisory Requirements:   

N/A 

Employment Requirements:  

Successful completion of background check including criminal record, driving record, abuse/neglect, and fingerprint check. 

Completion of New Hire Orientation at the beginning of employment. 

All training requirements including Relias at the beginning of employment and annually thereafter. 

Current driver’s license, acceptable driving record and current auto insurance. 

Physical Requirements: 

ADA Consideration - Sedentary work:  Exerting up to 10 pounds of force occasionally (exists up the 1/3 of the time) and/or a negligible amount of force frequently (exists 1/3 to 2/3 of the time) to lift, carry, push, or pull, or otherwise move objects, including the human body.  Repetitive movements of hands, fingers, and arms for typing and/or writing during work shift.  

Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met. 

Keywords: Compliance, Compliance Partner, Corporate Compliance, Training, Investigations, Risk Management, Healthcare Compliance, Regulatory Standards, Integrity, Policy Implementation 

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.