Professional Services - America’s PMO

Global Project Delivery - Professional Services - AMER- East Enterprise

Responsible for maintaining the Compliance ProgramDevelop and implement policies and proceduresEmployee training and In-ServicesMaintain DMEPOS AccreditationPerform Internal Audits and Quality Improvement activities,Pharmacy Compliance Training: HIPAA, Fraud Waste Abuse, and Methamphetamine MethCheck Pseudoephedrine Training.• Oversee day to day operations of the pharmacy and home medical divisions• Maintain ACHC accreditation standards, policies and procedures• Interview prospective hires and maintain employee records (W-4, NC-4)• Lead training activities for employees: HIPAA, Fraud Waste and Abuse• Assist with regulatory and third-party payer audits (desk and on-site)• Continually update staff on regulations and operational changes/efficiencies• Effectively plan, lead and manage monthly staff meetings• Manage pharmacy compliance obligations and documentation via PharmCAP• Maintain credentialing of the facility and pharmacists, including NPI & PECOS• Trained staff and managed the billing transition from ICD-9 to ICD-10• Daily inventory and supplies management for pharmacy and home medical• Assist Customer Service Representatives with DMEPOS billing knowledge

Durable Medical Equipment Providers across the United States were required to become Accredited by September 30, 2009 in order to keep their Medicare billing number (and ability to provide medical equipment to Medicare beneficiaries). My goal was to implement policies and procedures to comply with this mandate and propel our independent pharmacy and home medical company into the future with sound compliance practices. We were first Accredited on May 21, 2008 by ACHC, the Accreditation Commission for Health Care, Raleigh, NC and have since been re-accredited in 2011 for consecutive 3 year term.• Directed initial organizational DMEPOS accreditation mandated by CMS• Developed, implemented and enforced internal policies and procedures• Developed required in-service training for staff and management• Performed risk management assessments and Quality/Performance Improvement activities as required by ACHC, accrediting body• Maintained credentialing of the facility, pharmacists and registered nurse• Daily inventory and supplies management for pharmacy and home medical