Compliance Specialist jobs in Lafayette, LA

The Risk Management department of Acadian Ambulance has an opening for a full-time position as a Billing Compliance Specialist. This position will be responsible for compiling, analyzing, and documenting findings from internal and external audits for billing accuracy and compliance standards.

This position follows a Monday-Friday schedule, from 8 a.m. to 5 p.m. at the North University location. Remote work or work from home is not permitted.

Duties and responsibilities:

• Conduct monthly billing compliance audits and identify any areas of concern and risk

• Conduct focused audits, concentrating on particular areas of concern (i.e. accuracy of obtained and completed forms, signature validation, documented medical necessity, accurate mileage billing, proper procedure codes, proper ICD 10 codes, etc.), and handle analysis solely on that issue/process/concern

• Review emergency and non-emergency transports to confirm they were billed correctly under Federal Compliance Regulations/Guidelines

• Identify the requirements needed to bill a transport as an emergency and/or non-emergency, and determine that the transport was billed correctly based on those requirements

• Ensure medical necessity requirements for both emergency and non-emergency transports are documented and supported the reason for transport

• Review and analyze external billing audits, and submit any required documentation within the timeline provided

• Identify areas of potential risk associated with emergency and/or non emergency transports (i.e. accurate mileage, medical necessity documented, accurate patient information, appropriate forms obtained, etc.)

• Work closely with the billing compliance manager on any findings, risks, or areas of concern

• All other duties as assigned

Qualifications:

• HS Diploma or GED equivalent

• 5 years of Medicare experience preferred

• Excellent written and verbal communication skills

• Basic or paramedic clinical experience is preferred.

• Basic computer skills

• Excellent Problem solving abilities

• Excellent communication skills

• Possess strong organizational skills

• Ability to adhere to productive goals and department guidelines

• Demonstrate a strong work ethic, professionalism and the ability to work independently

• Familiarity with Centers for Medicare and Medicaid Services regulations for Ambulance

• Proficient in Google Products

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.