COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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   Current UPMC employees must apply in HR Direct

Compliance Auditor, Intermediate

  • Job ID: 004880375
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Finance
  • Department: Corporate Compliance
  • Location: , Pittsburgh PA
  • Union Position: No
  • Salary Range: $20 to $33.22 / hour

Description

Are you ready to take the next step in your auditing career? Consider the Compliance Auditor, Intermediate at UPMC!

Under the direction of the Manager of Compliance, the Compliance Auditor, Intermediate is primarily responsible for planning and conducting medical functions and financial chart audits, presenting audit results to employed practices, creating or overseeing the creation of appropriate audit spreadsheets, providing educational presentations to employed physician practices, completing special coding, projects, and providing coding/documentation/compliance support to employed and PSD staff. This position is primarily located onsite but could have workplace flexibility after training. This position could be located at either of these locations at UPMC Forbes Tower or UPMC Cancer Center. Join our team today! 

UPMC has a Center for Engagement and Inclusion that is charged with executing leading-edge and next-generation diversity strategies to advance the organization’s diversity management capability and its national presence as a diversity leader. This includes having Employee Resource Groups, such as Women Inspiring Talent in Heath Care in Finance (WITH) or PRIDE Health, that support the implementation of our diversity strategy.

Responsibilities:

  • Conduct UPMC wide auditing and monitoring to ensure coding/documentation combinations and medical record documentation adequately supports services coded and billed in accordance with the appropriate state and federal regulations and/or standards.
  • Validate the ICD-10-CM, CPT, and HCPCS codes or CPT and HCPCS ICD-10-CM-PCD and DRG assignment appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting.
  • Conduct audits on other compliance related topics as determined to evaluate compliance with the state and federal laws, regulations and policy.
  • Develop concise and well referenced audit workpapers.
  • Prepare written reports of audit results, including recommendations for improvement and compliance with state and federal laws and regulations.
  • Conduct post-audit compliance training sessions for physicians and non-physician practitioners as audit results dictate. These training sessions will include, but are not limited to, provision of education specific to the issues found on audit and will be largely based on the documentation, coding and billing rules as set forth by CMS and other relevant Federal and State regulatory agencies.
  • Maintain current knowledge and understanding of regulatory trends and changes in coding policy and reimbursement methods.

 

Qualifications

  • High School Diploma or equivalent required.
  • Associates Degree or comparable technical school diploma is preferred.
  • 3 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.
  • Proficiency with associated technology solutions such as Microsoft Excel, Word and PowerPoint is strongly preferred.
  • 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.


Licensure, Certifications, and Clearances:
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)ORRegistered Health Information Administrator (RHIA)Registered Health Information Technician (RHIT)ORLicensed Professional Nurse (LPN)Registered Nurse (RN)


UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

Security Alert

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If you suspect you have been a victim of a fraudulent UPMC job offer, please report the attempt using this form.