Authorization / EVV Compliance Specialist - Traditional Home Health Care

Traditional Home Health Care
**Industry leader with a CMS 4.5 Star rating in Northeast Pennsylvania**
**Voted Best Home Health Service-Readers' Choice 2023**
 

Job Title: Authorization / EVV Compliance Specialist
Job Location: Wilkes Barre, PA
Schedule: Monday - Friday 8:30-5:00pm (Onsite)

Job Description:

In this role, you will monitor processes that reduce write-offs, non-billable shifts, and EVV. In addition to monitoring overall EVV compliance by ensuring frontline employees are utilizing EVV as mandated by federal, state, or funding sources, the Compliance Specialist will provide coaching and training on EVV compliance. This is a collaborative role and works in partnership with schedulers, payroll and billing, to streamline processes, drive consistency, and trouble shoot EVV related problems that arise. This position requires a detail-oriented individual with strong technical proficiency, regulatory knowledge, and the ability to collaborate effectively across departments to ensure EVV compliance and operational efficiency in a healthcare environment.

Essential Job Functions/Responsibilities, but not limited to the following:

• Determine CHC/Medicaid eligibility.
• Train and guide office and field staff on effective system usage and processes.
• Ability to handle confidential information in compliance with HIPAA.
• Ability to lead change and innovation.
• Ability to manage multiple tasks daily and manage time efficiently.
• Review and process all pending approvals in the EVV system.
• Review completion of care plan for accuracy and alignment with care plan.
• Address EVV setup issues with office staff.
• Review over authorizations and discrepancies with schedules to prevent over payments.
• Escalate over authorizations and discrepancies with schedule to appropriate representatives.
• Run visit compliance report as final check of tasks and visits completed
• Assist users in setting up and configuring mobile applications on various smartphone platforms (iOS, Android, etc.).
• Collaborate closely with the Lead Compliance Specialist and Chief Information Officer to ensure compliance with Pennsylvania requirements.

Position Requirements and Qualifications:

• High school diploma or equivalent required (Associate’s or Bachelor’s degree preferred).
• Two (2) year verifiable work experience, preferably in a related capacity.
• Preferred experience with PA Medicaid State Aggregator Systems (e.g., Sandata, HHAeXchange).
• Able to work in a fast-paced work environment.
• Strong problem resolution skills with a focus on accuracy and efficiency.
• Excellent communication skills, both verbal and written.
• Exceptional organizational and time-management abilities.

Why Choose Traditional Home Health?

• Supportive Team and Environment
• Health Benefits offered
• Paid Time off
• Weekly pay
• Competitive Rates
• 401k Options
• Growing Company
• Long Standing employee retention
• Company Discounts
• Career Stability

At Traditional Home Health Care we listen, respect, and value your hard work. Join our team of professionals and make a difference in someone’s life.
Voted as the BEST Home Health Service in 2023, it is evident that our employees enjoy their job providing the best care in the area. We are known to treat our employees with excellence.

Traditional Home Health Care is a leader in the health care field providing skilled nursing/aide services and state of the art educational programs that have proven results. Our goals are clear: to restore the patient's health and increase patient confidence in their own abilities so that they may lead healthier more productive lives. To learn more about Traditional Home Health Care, please visit our website at

Equal Employment Opportunity

Traditional Home Health Care provides equal employment opportunity regardless of age, sex, color, race, creed, national origins, religious affiliation, marital status, sexual orientation, veteran's status or non-job-related disability. This is reflected in all employment practices and policies regarding hiring, training, transfers, rate of pay, termination and other forms of compensation. All matters relating to employment, salary and benefits are determined based upon ability to perform the job, as well as dependability once hired.
Job ID: 841259