Policy Specialist

Why join us?

We're on a mission to empower people with disabilities to do what they once did or never thought possible. As the world-leader in assistive communication solutions, we empower our customers to express themselves, connect with the world, and live richer lives.

At Tobii Dynavox, you can grow your career within a dynamic, global company that has a clear, impactful purpose - with the flexibility to also do what truly matters to you outside of work. What's more, you'll be part of a work culture where collaboration is the norm and individuality is welcomed.

As a member of our team, you'll have the power to make it happen. You'll solve challenges, deliver solutions and develop new, efficient processes that make a direct impact on our customers' lives.

What you'll do:

The Policy Specialist will be primarily responsible maintaining healthcare policies related to Medicaid and Waiver Programs. Secondary responsibilities include quality reviews based on payer specific criteria as well as monitoring and creating internal policies that align with department operations and responding to outside audit requests.

As a Policy Specialist, you will be responsible for:

Policy Review:

• Research, Analyze, and Maintain State Medicaid and waiver program requirements on a quarterly basis

• Work with Compliance Manager to determine states/programs that require policy changes to include adoption of coverage for Speech Generating Devices

• Maintain Provider Manuals for all State Medicaid Programs

• Communicate policy changes to key departments/stakeholders

• Create, modify and, update payer checklists in accordance with policies

• Research proposed changes to internal policy for compliance with CMS 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

Process Review and external audit management:

• Analyze, update, test, and train on internal policies related to compliance and audit findings

• Review/monitor internal processes for Funding and Billing and Collections

• Review/monitor internal processes for Solutions Consultants

• Prepare audit 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 as needed questionable documentation or practices.

Minimum Qualifications:

• Bachelor's Degree or 3 years equivalent experience

• 3 years of third-party payer experience

• Knowledge of DME Billing and Prior Authorizations

What you'll bring:

• 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

• Medical and/or legal terminology knowledge a plus

• Detail oriented

• Minimal travel may be required

• Ability to work with interruptions

• Thrive in a fast-paced work setting

Apply today!

We believe in empowering individuals - including our own employees - to reach their full potential. So, if you want to change lives while growing your own career, we'd love to hear from you.