Compliance Specialist

4 days ago

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AdaptHealth

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AdaptHealth is a company that provides healthcare solutions with a focus on respiratory health, sleep health, diabetes health, and wellness at home. With a network of 671 locations in 47 states, AdaptHealth delivers 38,225 home medical supplies each day and holds 2,825 insurance contracts. The company is dedicated to empowering patients to live their best lives, offering products and services such as CPAP machines, oxygen supplies, diabetes supplies, and a variety of medical equipment. AdaptHealth is highly rated by its customers for fast, reliable, and courteous service. They emphasize patient care solutions that integrate seamlessly into daily life, supported by online support and fast shipping services. Their mission is to change lives by providing the necessary healthcare tools to patients nationwide.

10,000+ employees

Founded 2019

⚕️ Healthcare Insurance

🧘 Wellness

📋 Description

• Conducts internal and external audit while adhering to audit schedules, including traveling to local sites to conduct audits and promoting the AdaptHealth compliance program • Collaborates with the leadership team of designated region, ensure compliance objectives are met • Provide compliance guidance and support regarding clarification of compliance requirements, accreditation standards • Participates in investigations of identified issues, gaps in adherence of our standards, and reported issues • Perform internal audits including, but not limited to on site reviews for compliance to HIPAA, Medicare, State, and accreditation requirements and post-payment claims reviews • May lead compliance investigations, mapping out strategy, approach, and after assessing facts and data, make a recommendation to the Chief Compliance Officer as to resolution • Document investigation results in a comprehensive, factual, and appropriate manner including rationale of findings and recommendations • Travel to branch locations as needed provide compliance support, conduct site audits and investigations • Assist operation managers and other business leaders in the development and execution of action plans for improvement and corrective/preventative action as necessary to address any deficiencies • Respond promptly and appropriately to all requests for assistance with compliance related matters, and function in a consultative, guiding capacity • Maintains awareness of when escalate issues of suspected non-compliance or items needing additional clarification or immediate attention from an executive • Research and respond to questions from supervisors and other employees regarding specific Medicare and other healthcare issues on a case-by-case basis • Ensure audit tracking is updated and changed per any process changes within AdaptHealth or per any criteria changes with Medicare/healthcare guidelines • Contact Medicare and other insurance carriers as needed for additional information regarding claim audits • Develop and maintain working knowledge of current HME products and services offered by the company • Maintains an understanding of Medicare and Medicaid criteria claims filing requirements, Medicare Supplier Standards, and accreditation requirements • Maintain patient confidentiality and function within the guidelines of HIPAA • Completes assigned compliance training and other educational programs as required • Maintains compliant with AdaptHealth’s Compliance Program • Perform other related duties as assigned

🎯 Requirements

• Associates degree from an accredited college is required; Bachelor’s degree preferred • Three (3) years of compliance or quality assurance experience is required • Experience Medicare, Medicaid, and third-party insurance related experience preferred • DME related experience preferred