Billing Compliance Specialist I

Acadian Companies is seeking a Billing Compliance Specialist I to join our Risk Management team. This role is responsible for maintaining the integrity of our billing processes by ensuring all claims adhere to federal, state, and payer-specific regulations. The ideal candidate needs to possess a strong attention to detail and a commitment to ethical billing practices, performing routine audits to mitigate risk and promote organizational transparency. This role operates under the direct supervision of the Billing Compliance Supervisor.

This position is onsite. While the primary work location is in Lafayette, placement at other Acadian administrative offices, including locations outside of Louisiana, may be considered based on business needs and workspace availability. Remote or hybrid work arrangements are not guaranteed and will be evaluated on a case-by-case basis. No work from home option available.

Essential Duties and Responsibilities:

• Review ambulance transport documentation for billing accuracy and regulatory compliance
• Verify documentation supporting medical necessity for emergency and non-emergency transports
• Compile, analyze, and document internal and external audit findings
• Prepare and submit audit responses within required timelines
• Identify compliance risks related to medical necessity, transport level, mileage, patient demographics, and required forms
• Track audit trends and recurring issues, escalating findings to leadership when appropriate
• Maintain accurate audit records and supporting documentation
• Participate in required compliance training and collaborative sessions
• Perform other duties as assigned in support of departmental objectives

Core Competencies:

• Attention to Detail - Accurately reviews documentation to ensure compliance and reduce risk.
• Analytical Thinking - Identifies patterns, trends, and potential compliance concerns.
• Integrity & Professional Ethics – Maintains objectivity and confidentiality in all compliance matters.
• Effective Communication – Clearly explains and collaborates with the direct supervisor on all issues and concerns identified.

Qualifications: 

• HS Diploma or GED equivalent
• Medicare Experience Preferred
• Basic or Paramedic clinical experience preferred
• Excellent written and verbal communication skills
• Advanced computer skills, including proficiency in Google Workspace (Docs, Sheets, etc.)
• Strong problem-solving abilities
• Possess strong organizational skills
• Ability to adhere to productive goals and department guidelines
• Demonstrate a strong work ethic, professionalism and work independently

Initial training may be conducted through a combination of virtual and in-person sessions. Employees who are not based at the Lafayette Headquarters will be required to travel to headquarters for training, team collaboration, and operational alignment.

Acadian Companies values internal growth and professional development. Employees are eligible for advancement consideration after a minimum of 12 months in the role, contingent upon successful training completion, performance metrics, and supervisor recommendation.