Medicaid EVV and Claims Specialist

Job Description - Medicaid EVV and Claims Specialist

Reports To: Associate Director - Medicaid EVV and Claims Team

Department: Customer Success
Location: Remote

Position Type: Full-Time

Position Summary

The Medicaid EVV & Claims Support Specialist at AxisCare plays a vital role in guiding and empowering homecare agencies through the complexities of Electronic Visit Verification (EVV) compliance and Medicaid claim processing. This role requires a deep understanding of the AxisCare user interface, Medicaid billing workflows, and the specific requirements of various state EVV systems and aggregators. 

This role demands strong analytical thinking, high attention to detail, and excellent communication skills. Specialists in this role deliver high-level support by resolving advanced technical and operational issues, onboarding enterprise-level agencies with complex Medicaid and EVV needs managing complex ticket workflows and acting as a subject matter expert and escalation point for EVV and claims-related concerns. 

In addition to client-facing support via phone, video calls and email, the role includes drafting and managing Engineering Support Desk (ESD) tickets, creating internal and client-facing documentation, delivering training, and identifying trends that inform product improvements and support strategies. The ideal candidate thrives in a fast-paced, collaborative environment and is passionate about helping agencies remain compliant. 

Key Responsibilities

• Support EVV and Claims Users: Analyze and resolve issues related to Medicaid EVV submissions, 837 claims, payer rejections, token mismatches, and other state or aggregator-related requirements. 
• Create and Manage ESDs: Build and troubleshoot Electronic Service Documentation (ESD) forms with a high degree of proficiency. Must be confident navigating the configuration tools and understanding the downstream impact of changes.
  
• Be an Escalation Point:
  Serve as a go-to resource for complex or unresolved EVV and claims issues. Act as a liaison between frontline support and internal teams or state aggregators when higher-level problem-solving is required.
  
• Troubleshoot with Confidence: Use your knowledge of state-specific EVV programs (such as Sandata, Tellus, HHAeXchange, LaSRS, and others) to guide customers through troubleshooting and resolution.
  
• Monitor and Respond to Incoming Requests: Actively monitor the Zendesk support queue and respond to client inquiries via phone and email, ensuring accurate, timely, and professional resolution of issues.
  
• Follow Through:
  Maintain thorough documentation in Zendesk, follow up on open tickets, and ensure clear client communication throughout the process.
  
• Report & Collaborate:
  Escalate bugs or recurring issues to internal Product or Engineering teams and contribute to collaborative troubleshooting.
  
• Contribute to Internal Knowledge:
  Help build and maintain knowledge base articles, training videos, and live trainings related to Medicaid workflows and EVV configurations.
  
• Stay Ahead of Changes:
  Monitor updates from state Medicaid programs and stay current with evolving EVV/claims requirements and industry best practices.
  
• Own Your Time:
  Arrive on time, follow through on commitments, and communicate proactively with clients and teammates.
  
• Enterprise/High Touch Onboarding:
  Proven ability to support onboarding for enterprise-level homecare agencies with complex Medicaid billing and EVV requirements using the AxisCare platform. Proven ability to support and troubleshoot during the onboarding of enterprise-level homecare agencies, particularly around complex Medicaid billing and EVV configurations.  

What We're Looking For (Minimum Qualifications)

• Bachelor's degree in a relevant field or equivalent work experience preferred
  
• 2+ years or prior experience in homecare operations, Medicaid billing, or healthcare software support, with specific experience handling EVV and claims required
  
• Deep understanding of Medicaid billing workflows, EVV requirements, and state-specific variations.
  
• Strong problem-solving skills with the ability to analyze complex workflows and data sets.
  
• Excellent written and verbal communication skills, especially when documenting processes or explaining technical issues to non-technical users.
  
• Experience with ticketing systems, CRM platforms, and knowledge base tools.
  
• Highly organized with the ability to manage multiple priorities in a fast-paced environment.
  
• Ability to work collaboratively in a team and independently when necessary.
   

Working Conditions 

• Manual dexterity required to use desktop computer and peripherals.
• Utilization of software and email to perform job functions.
• Will need to conduct camera-on videoconferencing for customer calls.  

Compensation and Benefits  

• Competitive salary and comprehensive benefits package.
• Medical insurance premiums are covered in full for the employee (Medical, Dental and Vision). 
• 401K with competitive company matching.
• Personal time off, sick leave, and holidays.
• Company will provide laptop and other needed computer equipment. 

About AxisCare
According to Pew Research, roughly 10,000 baby boomers turn 65 every day, and the American Society on Aging calculated that an American has a 70% chance of needing help with activities of daily living such as dressing, bathing, hygiene, etc. This has led to an unprecedented increase in Home Care agencies in the U.S. and abroad who strive to help those who have difficulty helping themselves, specifically offering non-medical (also referred to as non-skilled) services to seniors in their homes.
 
AxisCare was started in 2011 by industry leaders to help meet the demand for a more userfriendly and mobile-compatible solution. Our product is a web-based management platform that helps agencies manage CRM and marketing, Caregiver/Client scheduling, billing, payroll and much more. Headquartered in Waco, TX, AxisCare has clients in all 50 states as well as 7 other countries. We are a fast-growing company seeking high-performing individuals looking for a fast-paced, autonomous working environment.