The Director of Compliance, Billing will provide oversight of DJO’s Global Corporate Compliance and Ethics Program (“Program”), including but not limited to, management and enhancement of the Program with a focus on the Company’s billing compliance. The Director of Compliance, Billing will work closely and collaboratively with leaders of the billing organization to ensure compliance with all applicable laws, regulations and requirements, The Director of Compliance, Billing will develop Program policies and procedures, training, initiation and conduct confidential investigations, develop and implement corrective action plans, perform audits, conduct analysis of complex state and federal laws, regulations and Medicare billing policies related to DMEPOS suppliers, ensure compliance with Program policies and procedures, Medicare Supplier Standards, National Supplier Clearinghouse requirements, DME MAC requirements, Accreditation requirements, HIPAA privacy and security, and DME licensure. Ensure on-going culture of compliance and prevention of illegal and unethical conduct.
This position requires an experienced individual with ability to strategically and creatively address compliance challenges by planning, designing, implementing maintaining and monitoring the Program while working effectively with key business partners, including the company’s billing department, sales force and field service teams the in a fast-paced and highly regulated environment.
Essential Duties and Responsibilities (Other duties may be assigned):
Responsible for managing the day to day operations of compliance polices and procedure for DJO’s billing operations within the overall Compliance Program.
Consults with businesses to identify, formulate and implement policies and procedures to ensure compliance with federal, state, agency, legal, regulatory and internal requirements, including but not limited to billing Medicare, Medicaid and other government healthcare programs and selling and billing durable medical equipment, prosthetics, orthotics and supplies (“DMEPOS”).
Develops compliance training program and modules to ensure the effective implementation of policies and procedures
Provides compliance related expertise, advice and counsel to the billing department with respect to day to day operations.
Conduct and document investigations of alleged compliance violations, including hotline reports, and resulting corrective and preventative actions.
Develops annual audit plan and performs audits of billing operations and other high risk areas as appropriate.
Ensures coordination and communication within the Company on compliance matters.
Coordinates site, agency or other audits and examinations conducted by external parties, including Medicare, State Board of Pharmacy and other licensing boards, and accreditation organizations.
Monitors rules, regulations, industry standards and regulatory enforcement relating to government billing and DMEPOS suppliers and implements appropriate changes to the compliance program.
Possess strong presentation and negotiation skills as well as the ability to influence/change the thinking or gain acceptance of others in sensitive situations.
Oversees and prepares responses to customer inquiries, requests and complaints.
Prepares management reporting.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
12+ Yrs in compliance related role with a focus on the health care industry, preferably with a medical device manufacturer and/or DMEPOS supplier.
In-depth knowledge of healthcare compliance and applicable laws, regulations and standards (e.g., fraud and abuse, HIPAA, Stark, Anti-Kickback, Medicare reimbursement, Medicare Supplier Standards, DMEPOS Quality Standards etc.), preferably as they apply to medical device manufacturers and/or DMEPOS suppliers.
Ability to analyze and interpret complex healthcare regulations and apply to company business and operations.
BA/BS or Equiv Work Experience
Juris Doctor Degree or Master Degree;
15+ Yrs exp including 5+ Yrs Mgmt Experience
Internal Number: R18-1324
About DJO Global
DJO Global is a leading global developer, manufacturer and distributor of high-quality medical devices that provide solutions for musculoskeletal health, vascular health and pain management. Our products address the continuum of patient care from injury prevention to rehabilitation after surgery, injury or from degenerative disease, enabling people to regain or maintain their natural motion. Our products are used by orthopedic specialists, spine surgeons, primary care physicians, pain management specialists, physical therapists, podiatrists, chiropractors, athletic trainers and other healthcare professionals. In addition, many of our medical devices and related accessories are used by athletes and patients for injury prevention and at-home physical therapy treatment. Product lines include rigid and soft orthopedic bracing, hot and cold therapy, bone growth stimulators, vascular therapy systems and compression garments, therapeutic shoes and inserts, electrical stimulators used for pain management and physical therapy products. Our surgical division offers a comprehensive suite of reconstructive joint products for the hip, knee and shoulder. Our products are marketed under a portfol...io of brands including Aircast®, Chattanooga, CMF™, Compex®, DonJoy®, ProCare®, Exos™, Dr. Comfort®, DonJoy Performance® and DJO® Surgical.
For additional information on the Company, please visit www.DJOglobal.com.
DJO is a portfolio company of the Blackstone Group
EOE AA M/F/VET/Disability
All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of race, religion, color, national origin, sex, protected veteran status, disability, or any other basis protected by federal, state or local laws.