Megan Naglik
Summary
Dynamic and results-driven Senior Compliance and Policy Analyst with extensive experience in the healthcare sector, adept at advancing organizational goals through meticulous adherence to policies and procedures. Proven track record in meeting stringent deadlines for external audits and appeals, conducting thorough research, and reinforcing compliance standards. Skilled in delivering impactful training sessions and resolving complex audit challenges, consistently achieving favorable outcomes that safeguard company revenue. Committed to leveraging expertise to drive operational excellence and foster a culture of continuous improvement.
Overview
19
19
years of professional experience
Work History
Senior Compliance & Policy Analyst
Apria Healthcare
03.2022 - Current
- Served as the primary liaison for external auditing entities, including EXL and Performant.
- Acted as the central point of contact for internal stakeholders—co-workers, field staff, and management—facilitating task execution and employee training.
- Revised and maintained departmental process documentation to ensure operational consistency and alignment.
- Developed and managed spreadsheets for audit tracking and time study analysis to support performance monitoring.
- Secured NaviNet access to streamline and expedite audit submission workflows.
- Assumed Reimbursement Compliance Manager (RCM) responsibilities during periods of absence and supported additional assignments delegated by the RCM and department director.
- Acquired comprehensive knowledge of provider certification processes, including Medicare/Medicaid enrollment, licensing, revalidation, recredentialing, insurance certification, accreditation, and surety bonds.
Compliance & Policy Analyst
Apria Healthcare
01.2016 - 03.2022
Responsibilities:
- Collected, organized, and analyzed documentation required for both internal and external audits to ensure regulatory compliance.
- Conducted policy research and developed supporting materials, including spreadsheets and training guides tailored to specific payor requirements.
- Monitored business operations and payment discrepancies to identify and address potential issues proactively.
- Delivered onboarding and process training to new hires, enhancing team readiness and operational efficiency.
Key Accomplishments:
- Designed a comprehensive NIV spreadsheet to align with updated compliance standards and facilitate payor comparisons.
- Authored CCX audit process documentation to standardize procedures and improve audit readiness.
- Assisted in compiling critical documentation to support resolution of high-dollar appeals.
- Served as a primary point of contact for internal teams—including co-workers, field staff, and management—to coordinate task execution and ensure timely completion.
Customer Quality Lead
Coram/CVS Specialty Infusion
01.2013 - 01.2016
- Lead a team of 10-15 people on a daily basis to ensure accurate insurance verification, authorization, monthly orders, and productivity. Provide plans for organizing tasks amongst the team to improve results. Answer escalated calls from field staff/customers and also resolve complicated emails for patient set ups. Able to aid other teams with productivity and issues when their leadership is unavailable.
Accomplishments
- Lead team to maintain verification emails be sent out within an hour of receipt
- Provide strategic plan for the day in regards to reassigning, follow up, and new orders
- Assist co-workers with follow up/new orders when short handed
- Take on responsibility to be the main point of contact for co-workers, field staff, and managers
Suspended Billing Lead
Coram CVS Specialty Infusion
01.2012 - 01.2013
- Lead a team of 5-10 people on a daily basis to ensure accurate monthly orders, suspended goals, and productivity. Provided plans for organizing tasks amongst the team to improve results. Answered escalated calls from field staff/customers and also resolved complicated emails from the billing center. Able to aid other teams with issues when their leadership was unavailable.
Accomplishments
- Lead suspended billing prescription project. Delegated tasks to field staff to obtain prescriptions, was able to clear over $300,000.
- Lead team to reduce suspended billing numbers by half due to insurance, authorization, and prescriptions.
- Took on responsibility to be the main point of contact for co-workers, managers, and billing department questions.
- Accrued spreadsheets to track productivity, billing trends, and adjustments
Senior Customer Quality Specialist
Coram/CVS Specialty Infusion
01.2010 - 01.2012
- Verifying insurance, submitting authorization, answering calls from referrals/patients for enteral nutrition orders. Sent accurate orders to the branches for set up. Also helped co-workers with questions, follow ups, and set up.
Senior Cigna Customer Quality Specialist
Apria Healthcare
01.2007 - 01.2010
- Verifying insurance, submitting authorization, answering calls from referrals/patients for durable medical equipment orders. Sent accurate orders to the branches for setup. Also helped co-workers with questions, follow ups, and set up.
Education
High School Diploma -
Saint Mary’s Area High School
06-2004
Skills
- Analytical problem-solving
- Strong written communication skills
- Detail-oriented approach
- Strong verbal communication
- Logical problem-solving
- Strong organizational skills
- Policy evaluation
- Policy analysis
- Data reporting proficiency
Timeline
Senior Compliance & Policy Analyst
Apria Healthcare
03.2022 - Current
Compliance & Policy Analyst
Apria Healthcare
01.2016 - 03.2022
Customer Quality Lead
Coram/CVS Specialty Infusion
01.2013 - 01.2016
Suspended Billing Lead
Coram CVS Specialty Infusion
01.2012 - 01.2013
Senior Customer Quality Specialist
Coram/CVS Specialty Infusion
01.2010 - 01.2012
Senior Cigna Customer Quality Specialist
Apria Healthcare
01.2007 - 01.2010
High School Diploma -
Saint Mary’s Area High School
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