EVV Compliance Specialist

📋 Description

• Oversee EVV systems in real-time and reach out to caregivers who have not successfully clocked in or out to investigate the issue and request the paper timesheet.

• Adhere to escalation procedures when necessary.

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

• Submit retro schedule change requests and manual visit confirmation requests, following up until resolved and billing is finalized.

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

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

• Perform root cause analysis and resolve errors appearing on Excel reports, ensuring accurate data imports into our system, correct billing of claims to payers, and proper reconciliation in our systems.

• Act as a subject matter expert on all EVV systems, providing training to others as required.

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

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

• Foster positive working relationships with all staff to gain their cooperation and support.

• Assist in implementing enhancements to processes and electronic information systems to ensure ongoing organizational efficiency.

• Monitor and analyze EVV data to ensure effective functioning of procedures and processes.

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

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

• Ensure regular, predictable, and consistent attendance while being flexible to meet 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.

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

• Strong communication and interpersonal skills.

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

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

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

• Ability to work both collaboratively and independently.

• Required analytical and problem-solving skills.

• 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.

• PTO Plan.

• Retirement Planning.

• Life Insurance.

• Employee discounts.