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EVV Compliance Specialist

2 months ago

San Antonio, Texas, United States University Health System Full time
POSITION OVERVIEW AND RESPONSIBILITIES

The EVV Compliance Specialist plays a crucial role in ensuring adherence to state regulations regarding Electronic Visit Verification (EVV). This position is responsible for:

  • Reviewing and transmitting EVV data to maintain compliance with mandated state requirements.
  • Identifying areas of non-compliance, addressing claims-related concerns, and detecting potential fraud, waste, and abuse (FWA).
  • Collaborating with multiple departments to serve as the primary source of EVV information collection.
QUALIFICATIONS AND EXPERIENCE

To be considered for this role, candidates must possess:

  • A high school diploma or equivalent.
  • A minimum of five years of experience in the insurance, healthcare, or managed care sectors, including at least two years focused on claims processing.
  • Prior experience in claims auditing is essential.
  • Familiarity with EVV vendors and systems is preferred.