Healthcare Compliance Specialist (EVV)

Position Summary:

In this hybrid role you will be responsible for supporting Innovive Health’s Electronic Visit Verification (EVV) program. This role encompasses a broad range of responsibilities, including training, implementation, rollout, system management, ongoing support, and ensuring compliance with Innovive’s quality and contract requirements. The EVV Compliance Specialist is detail-oriented and will be responsible for overseeing the maintenance, accuracy, and optimization of the EVV system within our organization.

The EVV Specialist ensures regulatory compliance, facilitates staff training on EVV procedures, addresses system issues, and analyzes data for improvements. This role collaborates with departments to reinforce CMS requirements and provide EVV education. Ideal candidates will have a strong understanding of EVV technology, excellent communication, analytical skills, and effective collaboration with internal and external stakeholders.

What you'll do:

• Daily monitoring, verification and maintenance of Aggregator software and related reports to ensure accuracy of visit submitted and documentation of error discrepancies.
• Communicate issues regarding non-validated exceptions to appropriate staff to ensure documentation is completed.
• Review exception reports and resolve billing discrepancies and issues in a timely manner.
• Communicate with clinicians regarding visit issue inquiries.
• Maintain detailed records and documentation related to billing activities.
• Stay up to date on changes and updates to EVV & government billing regulations and requirements.
• Responsible for identifying service breaks and unutilized time and visit variations for all categories of clients and notifying management and other appropriate staff of any problems.
• Documents as program policy requires.
• Responsible for reviewing daily EVV activities for compliance with regulations and company policies and procedures.
• Assist users in setting up and configuring mobile applications on various smartphone platforms (iOS, Android, etc.).
• Conduct outreach to noncompliant individuals; determine the cause of noncompliance and assist them to become compliant with State regulations.
• Act as a trainer and guide for users, walking users through the process of enrollment and using mobile applications effectively.
• Answers various questions regarding EVV issues and assists users in troubleshooting issues with devices.
• Perform audits and quality checks of tasks completed by other specialists, if required.
• Identify issues and proactively reports operational challenges.
• Contribute to root cause analysis and escalation management.
• Other duties as assigned.

What you need:

• Knowledge of state EVV (Electronic Visit Verification) systems or similar systems, preferred
• Intermediate experience with Microsoft Suite operating systems
• Intermediate experience with Excel spreadsheets (pivots, lookups, ability to work with large files, etc.)
• Ability to read, interpret, and implement regulations and administrative rules from a variety of sources including the State and Federal government.
• Bachelor’s Degree, preferred
• Two years of homecare or healthcare experience or experience in health care or other service-related industry.
• Proven experience as a Billing Specialist or similar role.

We believe our employees are our greatest asset! What we offer:

• Competitive salary based on experience
• Comprehensive benefits package includes medical, dental, vision, disability, and life insurance
• 24 days of paid time off
• Paid Company Holidays
• 401k with company match
• Dayforce Wallet - voluntary benefit that gives you access to earned pay
• Wellness program
• Tuition reimbursement
• Online CEU credits
• Excellent career growth opportunities

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Frequently required to stand.
• Frequently required to walk.
• Frequently required to sit.
• Continually required to use hands and fingers.
• Frequently required to climb, balance, bend, stoop, kneel or crawl.
• Occasionally required to lift/push light weights (less than 25 pounds).
• Occasionally required to lift/push light weights (greater than 25 pounds).

Innovive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.