What do you want to do?
Are you looking to make an impact in someone’s life, while working in a fast paced environment?
The Policy Specialist will be primarily responsible maintaining policies related to Medicare, Medicaid and Commercial Insurance. Secondary responsibilities include internal and external auditing based on payer specific criteria as well as internal policies and procedures.
If you want to build a company rather than just work for one. If you take pride in honest, hard work and want to perform freely in an open environment where you can be yourself, you will feel right at home.
Where you´ll work
Tobii Dynavox is the world leader in eye tracking and speech generating devices - products that help individuals with speech and motor impairments live a richer and more independent life. Headquartered in Stockholm Tobii covers a global market with offices in USA, Germany, Norway, Japan and China. We give people a voice. We help people with various disabilities with their hands and their eyes, interact and communicate with technology, in completely new and often game changing ways.
Our Pittsburgh, PA office is located just minutes from “Dahntahn” Pittsburgh and here you will be working with more than 200 happy Tobiians in the most dynamic and friendly environment in all of Pennsylvania. We have everything from design, development, production, and customer service and support right here on site so whatever question you have, you will find the answer in house!
Are you a fan of cornhole tournaments, nacho bars and sharing passion? Then come on down…
- Researching, Analyzing and Maintain policies with Medicare, Medicaid, and Commercial Payers on a quarterly basis
- Communicating policy changes to key departments
- Creating, modifying and updating payer checklists in accordance with policies
- Research proposed changes to internal policy for compliance with federal guidance and payer requirements
- Creating, modify, and update internal policy as needed to meet business or compliance need
- Analyzing, updating, test, and train on internal policies related to processes and procedures
- Auditing internal processes for Funding and Billing and Collections
- Preparing audit summaries and present findings with improvement suggestions to affected departments
- Opening, following, and managing Corrective Action Plans stemming from internal auditing as needed
- Ensuring proper compliance with OIG requirements for exclusion checks of employees, report to payers as needed
- Responding to outside audit requests, gather required documentation, and review results to ensure internal policies and processes comply with payer requirements
- Auditing as needed questionable documentation or practices
EDUCATION / EXPERIENCE REQUIREMENTS (include relevant education and minimum years of experience typically required by the job):
- Bachelor’s Degree or 3-5 years equivalent experience
- 3 years 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
- Minimal travel may be required
- Communication skills using the spoken word
- Ability to see within normal parameters
- Ability to work with interruptions
- Thrive in a fast paced work setting
Please address your questions to Keyaira Germany, Keyaira.Germany@tobiidynavox.com and submit your resume through our website as soon as possible. Don't wait! At Tobii, we move quickly!
Tobii Dynavox values equality of opportunity, human dignity, and racial/ethnic and cultural diversity. Tobii Dynavox does not discriminate against individuals on the basis of race, color, sex, sexual orientation, gender identity, religion, disability, age, veteran status, ancestry, or national or ethnic origin.
Equal Opportunity Employer/AA Women/Minorities/Veterans/Disabled