Provider Support Specialist
Groups Recover Together
Job Level
Mid-LevelSenior
About the role
- Optimize billing and compliance operations across multiple states, supporting EVV, payor setup, and claim submission.
- Research and resolve EVV-related claim issues and rejections across multiple states.
- Coordinate with internal teams and external vendors to correct visit data and ensure successful claim resubmission.
- Maintain accurate staff demographic and schedule data to support compliant EVV workflows.
- Configure and maintain billing profiles in EMR systems for payor setup.
- Implement EVV workflows and payor onboarding for new states in collaboration with stakeholders.
- Partner with IT and Revenue Cycle teams to streamline system processes and integrations.
- Track and report on issue resolution efforts and compliance status.
- Develop and update SOPs and workflow documentation.
- Train staff on EVV procedures, system updates, and state-specific billing protocols.
- Engage with external aggregators or state agencies as needed to support compliance efforts.
- Other duties as applies.
Requirements
- Bachelor’s degree in Business, Health Administration, or a related field.
- Five or more (5+) years of experience in revenue cycle operations.
- Preferably within home health or post-acute care.
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Ability to compute rate, ratio, and percentage.
- Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
- Ability to write reports, business correspondence, and procedure manuals.
- Ability to effectively present information and respond to questions from leaders, team members, investors, and external parties.
- Strong written and verbal communications.
- Ability to understand, read, write, and speak English.
- Experience with multi-state EVV, EMR systems, and system configuration.
- Experience working with payor contracts and extracting key billing data elements.
- Familiarity with ticketing or service request platforms, API (Application Programming Interface)-based demographic workflows, and healthcare data systems.
- Prior experience training staff and creating SOPs to support revenue compliance and claim workflows.
- Strong analytical, documentation, and troubleshooting skills to identify and resolve systemic issues.
- Working knowledge of Medicaid billing processes and visit verification aggregator platforms.
- Demonstrated ability to collaborate across departments to improve workflows, resolve system issues, and align operations with compliance requirements.
- Ability to work independently with a high level of autonomy and ownership.
