Managed Services Specialist

As a Managed Services Specialist at AlayaCare, your main responsibilities include serving as a subject matter expert in U.S. Revenue Cycle Management (RCM) and Electronic Visit Verification (EVV), providing support for implementation and troubleshooting, and ensuring compliance and accuracy in billing processes. You will conduct customer readiness activities, oversee training, and collaborate with internal teams to develop scalable solutions and monitor regulatory compliance.

To qualify as a Managed Services Specialist at AlayaCare, candidates should possess 2-4 years of experience in Revenue Cycle Management and/or home health care, with at least 2 years focused on Medicaid home health services and EVV. A Bachelor's degree in a relevant field is required, along with strong communication and analytical skills. Familiarity with the AlayaCare platform is considered a plus, enhancing your candidacy.

A typical workday for a Managed Services Specialist at AlayaCare involves a mix of customer support, internal collaboration, and continuous learning. You will assist clients with EVV and billing queries, conduct quality assurance testing, training sessions, and escalate issues when necessary. Additionally, you’ll engage in compliance monitoring and work on projects that drive improvements in internal processes while staying updated on industry trends.

At AlayaCare, the work environment is open, collaborative, and highly supportive. You’ll have the flexibility to work in a hybrid model, blending in-office and remote work, all while being part of an innovative team aiming to make significant impacts in the home healthcare industry. The culture promotes transparency, diversity, and inclusion, ensuring everyone feels valued and heard.

AlayaCare is dedicated to the professional development of its employees, including those in the Managed Services Specialist role. You'll find numerous opportunities for career growth through ongoing training programs, learning initiatives, and clear pathways to advancement. Our culture encourages collaboration and innovation, allowing you to specialize further in your field or explore new areas within the organization.

When tackling billing issues related to EVV, I start by conducting a thorough analysis of the billing workflow to identify where discrepancies may arise. Communication is key, so I would engage with both team members and clients to gather relevant information. Documenting the findings and adapting our approach to troubleshooting will help efficiently resolve the issues, ensuring compliance.

To ensure clients are ready for EVV implementation, I focus on engaging them early in the process. I conduct thorough training sessions that cover essential functions, provide resources and documentation outlining the EVV requirements, and establish a clear communication channel to address questions and concerns as they arise. I also recommend mandatory quality checks to track progress leading up to the rollout.

I have over two years of experience working specifically with Medicaid home health services, where I developed a deep understanding of the regulations governing these services. This experience has equipped me with the knowledge necessary to address compliance issues, manage billing processes, and ensure that the required documentation meets all legal standards.

The most critical skills for a Managed Services Specialist include strong analytical abilities to scrutinize data and identify trends, excellent communication to facilitate training and support, and a solid understanding of compliance regulations within the home health space. Moreover, adaptability and problem-solving skills are essential for navigating the complexities of EVV and billing workflows.

I stay updated on relevant regulations in home healthcare by subscribing to industry newsletters, participating in professional organizations, and attending seminars or webinars focusing on regulatory changes. Consistent teamwork discussions and knowledge-sharing sessions within my organization also enhance my understanding of the evolving landscape of healthcare laws and regulations.

In a situation where a client disputes their billing, I would first listen carefully to their concerns to understand the root of the issue. Documentation and thorough analysis are essential, so I'd review billing records and any related EVV data. Following this, I would communicate with the client to explain the findings, ensuring transparency while seeking a solution that satisfies their needs.

I have extensive experience working with electronic billing systems, particularly in the context of home healthcare. This includes familiarity with configuring billing workflows, ensuring data accuracy, and troubleshooting issues related to electronic submissions. My background enables me to support clients effectively in maximizing the potential of these systems while maintaining compliance.

In my previous role, I collaborated on a project around implementing a new EVV system. I worked closely with cross-functional teams, including IT, compliance, and client support, to streamline the implementation process. By fostering open communication and sharing insights, we successfully integrated the system with minimal disruption, and my determination to ensure everyone understood their role was key to our success.

Key metrics to evaluate the effectiveness of EVV implementation include billing accuracy rates, the timeliness of claim submissions, client satisfaction scores, and the percentage of compliance with regulatory guidelines. Monitoring these metrics allows for continuous improvement and helps identify areas requiring additional support or training to enhance both operational efficiency and client outcomes.

During peak periods, I prioritize my workload by assessing deadlines and the urgency of tasks. Utilizing project management tools to visualize my tasks helps me stay organized. I ensure open lines of communication with team members to inform them of my priorities and collaborate on urgent issues, allowing us to work effectively as a team and meet all expectations.