**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. **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**