**Join UPMC Corporate Compliance as a Senior Compliance Auditor!**

Are you passionate about ensuring accuracy and compliance in healthcare documentation and billing? Do you thrive in a dynamic environment where your expertise can make a significant impact? UPMC Corporate Compliance is seeking a dedicated and detail-oriented **Senior Compliance Auditor** to join our team! This position will be based out of Forbes Tower in Pittsburgh, PA. This is an onsite position with the potential to work from home.

**Key Responsibilities:**

· **Comprehensive Auditing:** Conduct UPMC-wide audits to ensure medical record documentation supports the services coded and billed in accordance with state and federal regulations.

· **Code Validation:** Validate ICD-10-CM, CPT, and HCPCS codes to ensure consistency and efficiency in claims processing, data collection, and quality reporting.

· **Regulatory Compliance:** Conduct audits on various compliance topics to evaluate adherence to state and federal laws, regulations, and policies.

· **Reporting:** Prepare written reports of audit results, including recommendations for improvement and compliance with state and federal laws and regulations.

· **Stakeholder Communication:** Communicate audit findings and corrective actions to key stakeholders.

· **Leadership Advising:** Advise leadership on regulatory requirements for coding documentation and billing to ensure services are submitted according to payor guidelines and related regulations.

· **Knowledge Maintenance:** Stay current with regulatory trends and changes in coding policy and reimbursement methods.

**Why UPMC?**

At UPMC, we are committed to fostering a culture of compliance and excellence. As a Senior Compliance Auditor, you will play a crucial role in upholding our standards and ensuring the highest level of integrity in our operations. Join us and be part of a team that values your expertise and dedication to making a difference in healthcare compliance.

**Apply today and take the next step in your career with UPMC Corporate Compliance!**

+ High School Diploma or equivalent required.

+ Associates Degree or higher or comparable technical school diploma is required.

+ 4 or more years of experience in medical coding, billing, auditing and compliance.

+ Extensive knowledge of CMS, and third-party payer coding, billing, and documentation compliance regulations required (MS-DRG, APR-DRG, APC, APG, or ICD10-CM, HCPCS, CPT, Modifiers, etc.).

+ Knowledge of coding/classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M codes.

+ Experience in an academic medical center setting is strongly preferred.

+ Knowledge of key revenue cycle processes, and clinical documentation is strongly preferred.

+ Proficiency with associated technology solutions such as Microsoft Excel, Word and PowerPoint is required.

+ Must be able to demonstrate a high degree of professionalism, enthusiasm and initiative daily.

+ Must have strong interpersonal, organizational, analytical and communication skills.

+ Ability to work in a fast-paced environment.

+ Must have ability to manage multiple tasks and projects, and forge strong interpersonal relationships within the department and with other departments.

+ Ability to identify, interpret and summarize relevant policy and regulation in a clear and timely manner is essential.

+ Experience researching and interpreting regulation and performing internal investigations is essential.

+ Attention to detail is critical to the success of this position.

+ Excellent planning, communication, documentation, organizational, analytical, and problem-solving abilities.

+ Data Analytics experience is strongly preferred. **Licensure, Certifications, and Clearances:**

One of the following is required:

+ Certified Coding Specialist (CCS)

+ Certified Inpatient Coder (CIC)

+ Certified Evaluation & Management Coder (CEMC)

+ Certified Professional Medical Auditor (CPMA)

+ Certified Professional Coder (CPC)

+ Certified Medical Coder (CMC)

+ Registered Health Information Administrator (RHIA)

+ Registered Health Information Technician (RHIT)

+ Licensed Professional Nurse (LPN)

+ Registered Nurse (RN)

Required:

+ Act 34

**UPMC is an Equal Opportunity Employer/Disability/Veteran**