EVV Compliance Specialist

📋 Description

• Oversee EVV systems in real-time and reach out to caregivers who have encountered issues with clocking in or out, to identify the problem and request the paper timesheet.

• Adhere to escalation processes when required.

• Offer educational and training support to caregiver staff regarding the proper use of EVV systems to enhance compliance.

• Request changes to retro schedules and manual visit confirmations, following up until resolution and billing are achieved.

• Collaborate with insurance companies and EVV providers as needed to address demographic and/or authorization discrepancies within the EVV system.

• Conduct root cause analysis and rectify errors in EVV systems, ensuring accurate service hours and correct billing of claims to payers.

• Perform root cause analysis and resolve errors reflected in Excel reports, facilitating accurate data import into our system, proper billing of claims, and effective reconciliation of our systems.

• Act as a subject matter expert on all EVV systems and provide necessary training to others.

• Serve as a subject matter expert on billing regulations according to requirements established by payers, as well as state and federal agencies.

• Demonstrate excellent interpersonal and communication skills essential for engaging with customers and staff across all departments and branches.

• Foster positive relationships with all staff members to secure their cooperation and support.

• Assist in implementing enhancements to processes and electronic information systems to maintain ongoing efficiency throughout the organization.

• Monitor and analyze EVV data to ensure procedures and processes are functioning effectively.

• Provide support and assistance to Operations and/or Reimbursement departments as needed for special projects or requirements.

• Uphold a high level of confidentiality at all times due to access to sensitive information.

• Maintain regular, predictable, and consistent attendance while being flexible to accommodate departmental needs.

• Comply with all Medicare, Medicaid, and HIPAA regulations and requirements.

• Adhere to all regulations, policies, procedures, and standards.

• Perform additional duties as assigned.

⛳️ Requirements

• High school diploma or GED equivalent is required.

• Administrative experience is necessary; customer service experience is preferred.

• Strong communication and interpersonal skills are essential.

• Computer proficiency is required, including intermediate knowledge of Microsoft Excel.

• Familiarity with home care operations, particularly Horizon, is preferred.

• Understanding of state Electronic Visit Verification (EVV) systems is preferred.

• Ability to work collaboratively as well as independently.

• Strong analytical and problem-solving skills are required.

• Capability to read, interpret, and implement regulations and administrative rules from various sources, including state and federal government.

🏝️ Benefits

• Medical, Dental, and Vision Benefits.

• Continued Education opportunities.

• PTO Plan.

• Retirement Planning options.

• Life Insurance coverage.

• Employee discounts.