[Hiring] Compliance Specialist @Tobii Dynavox LLC

Role Description

The Compliance Specialist will be primarily responsible for completing the internal audits quality reviews as required by the Compliance Plan, managing corrective actions, and communicating with the monitored departments. Secondary responsibilities include responding to outside audit requests, working with insurance policies, and creating internal policies that align with department operations.

• Analyze, update, test, and train on internal policies related to compliance and audit findings
• Audit internal processes for Funding and Billing and Collections to ensure compliance through quality reviews
• Audit Solutions Consultants to ensure compliance through regular quality reviews
• Prepare audit quality review summaries and present findings with improvement suggestions to affected departments
• Open, follow, and manage Corrective Action Plans stemming from internal auditing as needed
• Ensure proper compliance with OIG requirements for exclusion checks of employees, report to payers as needed
• Respond to outside audit requests, gather required documentation, and review results to ensure internal policies and processes comply with payer requirements
• Audit questionable documentation or practices as needed
• Assist with policy review for Medicare, Medicaid, and Private Insurance
• Work with Compliance Manager to determine states/payers that require policy changes to include adoption of coverage for Speech Generating Devices
• Maintain policies and checklists with team members
• Communicate policy changes to key departments/stakeholders
• Research proposed changes to internal policy for compliance with federal guidance and payer requirements
• Create, modify, and update internal policy as needed to meet business or compliance needs
• Collaborate with cross-functional teams to provide updates on policy changes

Qualifications

• Bachelor’s Degree or 3 years equivalent experience
• 3 years of third-party payer experience
• Knowledge of DME Billing and Prior Authorizations
• Ability to work cooperatively as a member of a team
• Demonstrated ability to communicate with clinical and reimbursement specialists
• Ability to communicate at all levels within an organization
• ERP/CRM experience preferred
• MS Office, including MS Word and Excel
• Adobe Acrobat
• Understanding of FTP processes preferred
• Excellent organizational abilities
• Prioritization skills and deadline management
• Detail oriented
• Medical terminology knowledge
• Ability to work with interruptions
• Thrive in a fast-paced work setting
• Minimal travel may be required

Benefits

• Empowering individuals to reach their full potential
• Collaborative work culture where curiosity is celebrated