Job Description

Job Title: Auditor I
Job ID: 36085168
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Facility: Western Psychiatric Institute
Department: Finance
Location: 3811 O'hara Street, Pittsburgh PA 15213


Do you have experience with behavioral health operations?  Looking for a job with variety?  Look no further than the Auditor I role!  This position is supporting the Western Psychiatric Hospital.  The position will audit and evaluate revenue cycle operations across all departments for Point-of-Service, Patient Access Hospital POS sites and specialty specific accounts receivables.  This role provides support to and interacts with senior leadership, practice plan administration and staff throughout revenue cycle analysis/auditing.

  • Maintain Non Audit Plus Service Account. Enter Non Centralized Audits into the department databases. Review and distribute Centralized Audits when necessary. Verify Third Party Audit Payer Responsibility has been met per Third Party Chart Audit Process. Complete necessary documentation, post collection status code, prepare audit bill, UPMC Confidentiality Agreement and UPMC Insurance Audit Settlement Review Sheets.
  • Support Revenue Cycle self-audits to ensure compliance of all revenue cycle protocols, which may include auditing the following: accounts receivables, registration, referrals, scheduling, cash collections, denials and productivity.
  • Ensure timely resolution regarding completed Diagnosis Verification Requests as outlined in the Revenue cycle policies and procedures.
  • Maintain the Identity Theft Log. Review inquirieis, identify root cause i.e. charge positing error, registration error, EMPI error. Work with departments to correct accounts and charges. Complete OCPC Investigation Form when necessary for management review.
  • Complete Insufficient Documentation and CHP HPF Diagnosis Verification Request Queue(s).
  • Support and contribute to UPMC core values and guiding principles and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions.
  • Assist with Coding Reviews for focusing on modifier, CPT and diagnosis coding issues captured on the Clinical Billing Log. As applicable, work with HIM and Hospital Departments to resolve.
  • Maintain Third Party Auditor Calendar and Contact List making sure all information is current including Medical Record view access.
  • Effectively support assigned non clinical billing holds timely.


  • High School graduate or equivalent and two to four years of health insurance operations, claims processing or general auditing experience required.
  • Two to four years data entry experience.
  • Keyboard dexterity and accuracy.
  • Knowledge of medical terminology, ICD-10 and CPT coding.
  • Knowledge of HMO, POS, PPO, Medicare, SNP, CHIP and Medicaid plans.
  • Detail oriented with excellent organizational, interpersonal and communication skills.
  • Knowledge of MS Office products.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary Range: $16.72 to $26.54 / hour

Union Position: No

Apply Current Employee?


At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!


UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.


Now more than ever, YOU can help us shape our communities and UPMC into a better place for everyone to work, study, play, and thrive.

Learn more about working here and check out our policies and recent updates.

UPMC Health Plan Named Best Places to Work for LGBTQ Equality in 2019

UPMC Ranked #1 Best Places for Women and Diverse Managers in 2019

Talent Network