Drive proactive compliance initiatives in the dynamic landscape of Durable Medical Equipment (DME) and Complex Rehab, to safeguard company interests and ensure adherence to regulatory requirements.
Develop and implement comprehensive compliance programs and policies that align with CMS Medicare & DHCS Medi-Cal (Medicaid) standards, HIPAA regulations, government laws for DME providers, and accreditation requirements.
Conduct regular DME billing and HIPAA audits and assessments to identify compliance risks and deficiencies and develop strategies to mitigate them in alignment with accreditation and regulatory standards. Investigate allegations of non-compliance, fraud, or misconduct, and collaborate with relevant stakeholders to address issues promptly and effectively.
Provide guidance, training, and support to staff on compliance-related matters such as HIPAA standards, Fraud/Waste/Abuse, and any/all required industry specific topics.
Monitor and track compliance metrics, accreditation status, and regulatory updates, and prepare regular reports for senior management, including Quarterly Performance Improvement, to assess compliance performance and identify areas for improvement.
Serve as a liaison with accrediting bodies, regulatory agencies, auditors, and external stakeholders to facilitate compliance-related inquiries, audits, and inspections.