Compliance Specialist
Job Description
REQUIREMENTS
- Minimum of 2–3 years in a DME environment or healthcare compliance role.
- Proficiency in DME software platforms (e.g., Brightree, NikoHealth) and remote monitoring tools (e.g., AirView, React Health Connect).
- Exceptional interpersonal skills with the ability to provide “concierge-style” support to patients who may be frustrated with their equipment.
- An eagle eye for spotting inconsistencies in medical records that could lead to claim denials.
- Certified Healthcare Compliance (CHC) or similar certification.
- Practical knowledge of PAP therapy, including mask selection, fitting, and troubleshooting to support patient adherence
- Respiratory Therapist (RT) or Sleep Tech background is a significant plus but not required.
RESPONSIBILITIES
- Adherence Monitoring: Monitor patient equipment usage data (e.g., CPAP/BiPAP downloads) to verify that patients are meeting compliance milestones.
- Proactive Clinical Outreach: Identify patients struggling with adherence. Initiate empathetic, timely outreach to troubleshoot issues, provide encouragement, and ensure patients are sleeping better through consistent therapy.
- Interdepartmental Liaison: Work closely with the billing and intake departments to resolve “held” claims caused by missing or non-compliant documentation.
- Patient Outreach: Contact patients and physician offices to obtain necessary clinical updates or to discuss equipment non-compliance issues.
- Reporting: Maintain detailed compliance logs and prepare monthly reports for leadership regarding audit findings and adherence rates.
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