Compliance & Policy Analyst

Compliance & Policy Analyst

Apria Healthcare is the largest provider of home healthcare products and services in the United States, offering a comprehensive range of home respiratory therapy, home infusion therapy and home medical equipment services to over 2 million patients annually in all 50 states through approximately 550 locations. We are committed to full-service homecare solutions that give maximum independence to our patients. Please visit our website at .

• Responsible for obtaining, organizing, reviewing and analyzing all documents required for external and internal audits; including Medicare, Medicaid and private insurance. Responsible for reviewing audit documentation for any reimbursement issues as directed by manager.
• Assists with obtaining, organizing, reviewing and analyzing all documents required for internal investigations.
• Assists with all external and internal audits including notification and reporting audit results to manager.
• Responsible for notifying manager of recoupment and refund request notifications received from PFS/billing centers, as applicable. Responsible for maintaining documentation related to recoupments and refunds resulting from an external/internal audit.
• Analyzes and researches, for purposes of audits, government policies and procedures specific to the company's business unit/location.
• Responsible for maintaining current manuals/updates for all government payors assigned by manager.
• Assists with creation of training materials for all state welfare programs affiliated with region/division and ensures that branches and billing centers have all necessary material.
• Provides training and support as required to ensure all involved staff are properly trained on government compliance policies and audit procedures.
• Assists in researching policy and updating the applicable electronic systems related to all state welfare programs affiliated with region/division to ensure that all branches and billing centers have all necessary material.
• Assists in the revision and implementation of Apria and Coram policies and procedures that relate to government compliance. Assures that updated policies and procedures have been updated on the company's website.
• Assists with computer system issues, updates, and changes as required to implement new payor guidelines or Apria and Coram policies and procedures
• Communicates and reinforces company policies and procedures.
• Ensures compliance to company policies and procedures for all product lines. This includes federal, state, and local regulations.
• Actively participates in meetings of the Compliance Department on compliance improvement activities.
• Performs other related duties as directed by supervisor.

Qualifications:

• Education or experience equivalent to a two to four-year college degree is required.
• At least four years related experience is required.
• Excellent training and communication skills.
• Familiarity with medical terminology.
• Ability to read and interpret regulations and implement as required by the Company.
• Valid driver's license and appropriate insurance coverage.
• Leadership skills and negotiation skills required.
• General understanding of health and related types of insurance coverage, as well as the managed care industry and its operations.
• General understanding of contracting structures in durable medical equipment and home infusion industry.
• Computer knowledge (i.e. Microsoft Word, Excel and Access) is preferred.

PHYSICAL DEMANDS

• Requires constant sitting with occasional standing, walking, kneeling and stooping.
• Requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms.
• Constant talking and hearing.
• Specific vision abilities required include close vision, color vision, peripheral vision, and the ability to adjust focus.
• Must regularly lift and/or move up to 10 pounds.

Apria Healthcare (or Coram Healthcare ) is an equal opportunity employer. All employment decisions are made without regard to race, color, age, gender, gender identity or expression, sexual orientation, marital status, pregnancy, religion, citizenship, national origin/ancestry, physical/mental disabilities, military status or any other basis prohibited by law.
Because Apria believes in providing a safe work environment, we conduct drug and background checks in our recruiting/hiring processes. AA/EOE, M/F/D/V