Job Details

EVV Services Management

Main point of contact for all aspects of the management of EVV (electronic visit verification) services through AuthentiCare, to include setting up and terminating access for users, workers, device updates, authorization management, and claim auditing and processing. This position is being established to be in compliance with Section 12006(a) of the 21st Century Cares Act which mandates that states implement EVV for all Medicaid personal care services. This position will also assist with patient insurance eligibility validations.

Employee must be able to complete complex tasks by applying CCBHC practices, standard office policies, authorized instructions, and past precedents to achieve a desired outcome. Employee must quickly recognize emergency or sensitive situations and take appropriate action. Critical decision making and the ability to think through the consequences of a decision are essential in this position.

Management of Access Controls to the Web Portal:

• Assign and maintain user access to the various COMCARE locations within AuthentiCare
• Setup and maintain workers on the various COMCARE locations within AuthentiCare and communicate user/worker credentials to the employee/contractor
• Terminate access in AuthentiCare when staff separate from employment
• Maintain user account information to include device ID updates, reporting lost phone, etc.

Authorization and Claim Management:

• Confirm and Approve pending authorizations in the AuthentiCare website
• Inhibit Services daily in Avatar to stop them from claiming to payor
• Run inhibit services report each month to review inhibited services
• Daily review of services in AuthentiCare to verify any critical exceptions
• Daily review of services in AuthentiCare to confirm for billing
• Daily review of applicable service in Avatar to ensure they are loaded in AuthentiCare
• Monthly audit of remaining mismatched services between electronic medical record and AuthentiCare and community discrepancies to applicable staff/contractor
• Manual creation of claim in AuthentiCare as needed

Management of Patients:

• Patient demographic maintenance including updating patient phone numbers
• Entering new patients into AuthentiCare in order for workers to record visits
• Verify and update inhibited patient addresses
• Validate patient Medicaid eligibility dates
• Update insurance coverage on the patient account and retrobill any affected charge

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