EVVA Auditor (Electronic Visit Verification), El Paso Health

Job Summary
Responsible for assessing Electronic Visit Verification (EVV) activities for compliance with regulatory requirements and El Paso Health (EPH) programmatic standards. Responsible for extracting, reviewing, and disseminating EVV reports to ensure adherence to regulations for Long Term Services and Supports (LTSS) providers serving EPH’s lines of business. Accountable for reconciling reports and transactions to identify areas of non-compliance, claims-related issues, and potential fraud, waste, and abuse (FWA). Responsible for staying abreast of federal and state level regulations that govern EVV services.  Serves as the internal subject matter expert for EVV.  

Skills
1. Knowledge of auditing concepts and statistical analysis methods.
2. Strong knowledge of MS Office tools including Excel, Word, Outlook, Power Point. 
3. Ability to perform in an environment involving quotas for auditing standards.
4. Ability to review data to spot inconsistencies and potential fraud or misuse related to EVV services.
5. Ability to analyze and solve problems.
6. Ability to seek out new methods and principles to improve services.
7. Strong verbal and written communication skills.
8. Ability to maintain the utmost level of confidentiality at all times.
9. Ability to analyze information and assess risks effectively, leading to sound conclusions.
10. Familiarity with laws and guidelines that govern both EVV and FWA.

Work Experience
Three years of experience in auditing medical coding or billing records required.  Proficient understanding of Medicare and Medicaid billing guidelines, as well as strong familiarity with ICD-10, CPT, CMS, HCPCS, American Medical Association standards, Medicaid, and Correct Coding Initiatives preferred.  Knowledge of fraud and abuse regulations is highly preferred.  Experience with Electronic Visit Verification (EVV) preferred.

License/Registration/Certification
Certified Coding Specialist – Physician (CCSP) certification from the American Health Information Management Association or American Association of Professional Coders (CPC) required within one year of being in the position.

Education and Training
Bachelor degree in a healthcare related field is required.