Electronic Visit Verification; EVV Specialist

Overview

Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states. We are hiring a Full-Time Electronic Visit Verification (EVV) Specialist to provide support in Newtown, PA or Princeton, NJ
. The EVV Specialist is the subject-matter expert responsible for ensuring accurate Electronic Visit Verification (EVV) compliance and successful EVV-based claim submission across multiple states. This role owns the identification, prevention, correction, and education related to EVV denials and is accountable for improving clean-claim rates and reducing EVV-related revenue loss. The EVV Specialist partners closely with state-level operational staff, billing teams, and leadership to document state-specific EVV rules, proactively correct issues before claim submission, and drive consistent, compliant EVV practices across the organization.

Starting Salary: $65,000 per year

• Serve as the organization’s EVV subject-matter expert for assigned states
• Learn, maintain, and document state-specific EVV requirements
• Monitor regulatory changes and payer updates impacting EVV compliance
• Identify the top EVV denial reasons by payer and state
• Develop and enforce pre-submission EVV validation processes to prevent denials
• Ensure EVV visits are properly matched to claims prior to billing
• Collaborate with billing teams to ensure EVV data flows correctly into claim systems
• Support resubmission and correction of EVV denied claims when appropriate
• Analyze EVV denials and trends across all states
• Determine root causes (system, workflow, staff, authorization, or compliance)
• Create standard correction workflows for common EVV denial types
• Track resolution outcomes and recovery rates
• Escalate systemic issues and recommend process improvements
• Develop standardized job aids, checklists, and reference guides
• Continuously improve EVV workflows based on performance data
• Train state-level staff on EVV best practices
• Coach and support staff to achieve higher EVV compliance and clean-claim rates
• Provide regular reporting and insights to leadership
• Additional tasks and responsibilities may be assigned

• 3+ years of hands on experience with EVV systems and EVV-based claim submission
• Strong understanding of Medicaid EVV requirements
• Proven experience resolving EVV denials and improving claim acceptance
• Experience working across multiple states and payers
• Ability to interpret payer manuals, state guidance, and denial codes
• Strong documentation and process-mapping skills
• Excellent communication and training skills
• High attention to detail and strong analytical ability
• Experience supporting large multi-state provider organizations
• Familiarity with common EVV vendors (e.g., Sandata, Authenti Care, AHCCCS, HHAeXchange, Tellus, Care Bridge, etc.)
• Revenue cycle or billing background
• Experience working with Managed Care Organizations (MCOs)
• Knowledge of home care, personal care, or waiver services

• Competitive Insurance Benefits (Medical, Dental, Vision)
• Paid Holidays—Including a Birthday Holiday
• Generous PTO
• Employee Incentive & Discount Programs
• 403b Retirement Plan
• Incredible career growth opportunities
• University partnerships that include tuition reduction

Please Visit Our Website to Complete an Online Application! Careers.comop.org

Community Options is an Equal Opportunity Employer M/F/D/V