Compliance Specialist

Job not on LinkedIn

11 hours ago

🔔 Pennsylvania – Remote

Although this job is listed in Pennsylvania, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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Tobii Dynavox

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Healthcare Insurance • HR Tech • Wellness

Tobii Dynavox is a company dedicated to developing and providing assistive technology solutions for people with communication disabilities. They offer a range of products including augmentative and alternative communication (AAC) devices, eye-tracking technology, and communication apps. Tobii Dynavox aims to enhance the lives of individuals with conditions such as ALS, autism, and cerebral palsy by enabling effective communication through speech-generating devices and cutting-edge technology. The company also provides training, support, and a variety of accessories to support their extensive product line, focusing on personalizing solutions to meet individual needs. Tobii Dynavox products are used globally by individuals, professionals, and organizations.

201 - 500 employees

Founded 2001

⚕️ Healthcare Insurance

👥 HR Tech

🧘 Wellness

📋 Description

• Complete internal audits quality reviews as required by the Compliance Plan • Manage corrective actions and communicate with monitored departments • Respond to outside audit requests • Work with insurance policies and create internal policies that align with department operations • Analyze, update, test, and train on internal policies related to compliance and audit findings • Ensure internal processes for Funding and Billing and Collections comply with internal processes through 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 • 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

🎯 Requirements

• 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

• Flexible work arrangements • Professional development opportunities