Electronic Visit Verification (EVV) Specialist
full-time•Princeton
About this role
Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states.
We are now hiring a Full-Time Electronic Visit Verification (EVV) Specialist to provide support in Newtown, PA or Princeton, NJ. The Electronic Visit Verification (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
Responsibilities
- 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
Minimum Requirements
- 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, AuthentiCare, AHCCCS, HHAeXchange, Tellus, CareBridge, etc.)
- Revenue cycle or billing background
- Experience working with Managed Care Organizations (MCOs)
- Knowledge of home care, personal care, or waiver services
Why Community Options?
- 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
#IND-NA
Other facts
Tech stack
EVV Systems,Claim Submission,Medicaid Requirements,Denial Resolution,Documentation Skills,Communication Skills,Analytical Ability,Multi-State Experience,Revenue Cycle,Billing Background,Home Care Knowledge,Training Skills,Process Mapping,Payer Manuals,Compliance,Workflow Improvement
About Community Options, Inc.
Community Options, Inc. is a national nonprofit organization that develops innovative housing and employment opportunities for people with developmental disabilities. Since 1989, we have moved people with disabilities from segregated institutions across the country into community-based homes where they can fully participate in their communities and experience a greatly improved quality of life. We have designed and implemented the most progressive employment options giving people with disabilities a choice about the type of work they do and where they do it. We offer people with disabilities real work for real pay.
Community Options supports over 6,000 people with disabilities and families across twelve states: Arizona, Iowa, Maryland, New Hampshire, New Jersey, New Mexico, New York, Pennsylvania, South Carolina, Tennessee, Texas, and Utah.
Team size: 5,001-10,000 employees
Website: http://www.comop.org
LinkedIn: Visit
Industry: Non-profit Organizations
Founding Year: 1989
What you'll do
- The EVV Specialist serves as the subject-matter expert for Electronic Visit Verification compliance and oversees the claim submission process. They are responsible for identifying and correcting EVV denials while collaborating with various teams to ensure compliance and improve clean-claim rates.
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Frequently Asked Questions
What does a Electronic Visit Verification (EVV) Specialist do at Community Options, Inc.?
As a Electronic Visit Verification (EVV) Specialist at Community Options, Inc., you will: the EVV Specialist serves as the subject-matter expert for Electronic Visit Verification compliance and oversees the claim submission process. They are responsible for identifying and correcting EVV denials while collaborating with various teams to ensure compliance and improve clean-claim rates..
Why join Community Options, Inc. as a Electronic Visit Verification (EVV) Specialist?
Community Options, Inc. is a leading Non-profit Organizations company.
Is the Electronic Visit Verification (EVV) Specialist position at Community Options, Inc. remote?
The Electronic Visit Verification (EVV) Specialist position at Community Options, Inc. is based in Princeton, New Jersey, United States. Contact the company through Clera for specific work arrangement details.
How do I apply for the Electronic Visit Verification (EVV) Specialist position at Community Options, Inc.?
You can apply for the Electronic Visit Verification (EVV) Specialist position at Community Options, Inc. directly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process. You can also learn more about Community Options, Inc. on their website.