EVV Compliance Specialist (Electronic Visit Verification)

Addus HomeCare; Frisco (TX); Remote; USD 52,000 - 76,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Continued Education

PTO

Retirement planning

Life Insurance

Employee discounts

Job summary

Addus HomeCare is seeking an EVV Compliance Specialist to monitor electronic visit verification across multiple states, communicate with caregivers and branch staff, and reconcile data from Excel reports. The role emphasizes training, issue resolution, and ensuring accurate billing to payers while maintaining regulatory compliance.

The position supports flexible remote work (Mon-Fri, 8am-5pm) and offers comprehensive benefits including medical, dental, vision, PTO, and retirement planning.

Qualifications

• High school diploma or GED equivalent.
• Administrative experience required; customer service experience preferred.
• Strong communication and interpersonal skills.
• Computer proficiency; including intermediate Excel knowledge.
• Knowledge of home care operations; Horizon preferred.
• Knowledge of state EVV systems preferred.
• Ability to work both collaboratively and independently.
• Analytical and problem solving skills.
• Ability to read, interpret and implement regulations from state and federal sources.

Responsibilities

• Monitor EVV systems in real-time and contact caregivers who have not clocked in/out to resolve issues.
• Provide training assistance to caregiver staff on EVV systems to drive compliance.
• Request retro schedule changes and manual visit confirmations and follow up until billing is complete.
• Coordinate with insurance payers and EVV vendors to resolve demographic/authorization issues.
• Perform root-cause analysis to correct EVV errors for accurate service hours and billing.
• Create and maintain Excel reports to ensure correct data imports and reconciliations.
• Act as SME for EVV systems and educate others as needed.
• Ensure compliance with billing rules per payer, state, and federal regulations.
• Maintain confidentiality and professional interactions with customers and staff.

Skills

Home care operations

EVV knowledge

Excel proficiency

Communication skills

Team collaboration

Education

High school diploma or GED

Tools

Excel

Job description

Position Summary: The EVV Compliance Specialist is responsible for a variety of daily tasks related to managing the electronic visit verification (EVV) systems across multiple states. Tasks will include monitoring the EVV systems in real-time, communicating with caregivers, branch staff and insurance payers and working from Excel reports to reconcile data between multiple systems.

• Knowledge of home care operations, including Horizon preferred
• Knowledge of state Electronic Visit Verification (EVV) systems preferred

Schedule: Mon-Fri 8am-5pm (Remote)

> We offer our team the best <<

• Medical, Dental and Vision Benefits
• Continued Education
• PTO Plan
• Retirement Planning
• Life Insurance
• Employee discounts

Essential Duties:

• Monitor EVV systems in real-time and contact caregivers who have not clocked in or out successfully, in order to understand the issue and request the paper timesheet. Follow processes for escalation when necessary
• Provide educational/training assistance to caregiver staff on appropriate use of the EVV systems in order to drive compliance
• Request retro schedule change requests and manual visit confirmation requests and follow up until resolved and billing is complete
• Work with insurance companies and EVV companies as necessary to resolve demographic and/or authorization issues within the EVV system
• Complete root cause research and resolve errors in EVV systems; resulting in accurate service hours and the correct billing of claims to payers
• Complete root cause research and resolve errors populating on Excel reports, resulting in information accurately importing into our system, the correct billing of claims to payers and our systems accurately reconciling
• Serve as subject matter expert on all EVV systems and provide training to others as needed.
• Serve as subject matter expert on rules surrounding billing in accordance to regulatory requirements set forth by payers, state, and federal agencies.
• Exhibit excellent interpersonal and communication skills necessary to interact with our customers and staff members in all departments and branches.
• Maintains positive working relationships with all other staff to gain their cooperation and support.
• Provide support in implementing improvements to processes and electronic information systems to ensure ongoing efficiency across the organization.
• Monitoring and trending EVV data to ensure procedures and processes are working properly.
• Providing support and assistance to Operations and/or Reimbursement departments as needed for specials projects or needs.
• Maintains a high degree of confidentiality at all times due to access to sensitive information
• Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
• Follows all Medicare, Medicaid, and HIPAA regulations and requirements
• Abides by all regulations, policies, procedures and standards
• Performs other duties as assigned

Performance Responsibilities:

• Maintains positive internal and external customer service relationships
• Maintains open lines of communication
• Plans and organizes work effectively and ensures its completion
• Meets all productivity requirements
• Demonstrates team behavior and promotes a team-oriented environment
• Actively participates in continuous quality improvement
• Represents the organization professionally at all times

Position Requirements & Competencies:

• High school diploma or GED equivalent
• Administrative experience required; customer service experience preferred
• Strong communication skills and interpersonal skills
• Computer proficiency required; including intermediate level knowledge in Microsoft Excel
• Knowledge of home care operations, including Horizon preferred
• Knowledge of state Electronic Visit Verification (EVV) systems preferred
• Ability to work collaboratively and individually
• Analytical and problem solving skills required
• Ability to read, interpret and implement regulations and administrative rules from a variety of sources including the State and Federal government

Employee wellbeing is top priority at Addus Homecare, and we're thrilled to announce our recognition as the top healthcare company on Indeed's 2024 Top 100 Work Wellbeing Index. View the full rankings here: https://www.indeed.com/employers/work-wellbeing/work-wellbeing-100-ranking.