Service Verification Specialist

Service Verification Specialist Wyncote, PA Job Details Full-time $16 - $20 an hour 19 hours ago Benefits Paid holidays Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Opportunities for advancement Life insurance Qualifications Record keeping Document review (document control) Microsoft Excel Microsoft Outlook Medicare Managed care Caregiving Internal compliance auditing Process improvement Mid-level Administrative experience High school diploma or GED Quality assurance audits Quality audits Associate's degree Home health agency experience Healthcare compliance Documentation review Communication skills Cross-functional communication Time management Full Job Description We are seeking a detail-oriented and organized Service Verification Specialist to join our home care agency team. This position is responsible for verifying caregiver visits, ensuring service documentation is accurate, and supporting billing readiness by confirming that all scheduled services are properly authorized, documented, and compliant with agency, payer, EVV, and HHAeXchange requirements. The ideal candidate will have strong administrative skills, experience working in home care or healthcare operations, and the ability to communicate effectively with caregivers, coordinators, payers, and internal departments. Key Responsibilities Review and verify caregiver visit records for accuracy, completeness, and compliance. Confirm that visits were completed as scheduled and properly documented in the EVV system, including HHAeXchange . Monitor and resolve visit exceptions in HHAeXchange , including missed clock-ins, missed clock-outs, telephony issues, manual entries, and documentation mismatches. Identify missing, incomplete, or mismatched visit data and follow up promptly with caregivers, coordinators, or supervisors. Validate service authorizations, units, and eligibility before billing. Ensure visit records in HHAeXchange align with the care plan, authorization, and agency schedule. Work closely with scheduling, payroll, billing, and compliance departments to resolve discrepancies affecting service verification. Track and report service verification issues that may delay billing or payroll processing. Assist with pre-billing audits to confirm claims are supported by accurate service documentation and verified visits. Maintain accurate records of follow-up efforts, corrections, and outstanding issues. Communicate with field staff regarding documentation corrections, EVV compliance, and visit verification requirements. Support internal audits and quality assurance reviews related to visit verification, EVV, and HHAeXchange documentation. Help ensure compliance with Medicaid, MCO, EVV, HHAeXchange , and agency documentation standards. Perform other administrative and operational duties as assigned. Qualifications High school diploma or equivalent required; associate's or bachelor's degree preferred. Previous experience in home care, healthcare administration, billing support, EVV, scheduling, service verification, or HHAeXchange preferred. Knowledge of EVV systems, visit verification processes, home care documentation, and HHAeXchange is strongly preferred. Understanding of Medicaid and managed care documentation requirements is a plus. Strong attention to detail and problem-solving skills. Excellent organizational and time management abilities. Ability to handle multiple tasks and meet deadlines in a fast-paced environment. Strong written and verbal communication skills. Proficiency in Microsoft Office, especially Excel, Outlook, and Word. Ability to maintain confidentiality and handle sensitive information professionally. Preferred Skills Hands-on experience working in HHAeXchange and resolving visit exceptions. Experience working with caregiver timesheets, authorizations, and billing readiness processes. Ability to identify trends in documentation or EVV errors and recommend process improvements. Comfortable communicating with caregivers and staff to obtain corrections quickly and accurately. Strong follow-up skills and ability to work independently. Work Environment Office-based role with frequent communication with field staff and internal departments. May require occasional overtime during payroll or billing deadlines. Benefits Competitive pay Health, dental, and vision insurance Paid time off Holiday pay Opportunities for growth and advancement

Pay:

$16.00 - $20.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance

Work Location:

In person