Pittsburgh, Pennsylvania, United States · Hybrid
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Skills: Healthcare Compliance, Auditing, Medical Terminology, HIM Coding, Reimbursement Methodologies
Pittsburgh, Pennsylvania, United States · On-site
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Pittsburgh, Pennsylvania, United States · Remote Solely
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Pittsburgh, Pennsylvania, United States · On-site
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Pittsburgh, Pennsylvania, United States · Hybrid
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Pittsburgh, Pennsylvania, United States · On-site
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Pittsburgh, Pennsylvania, United States · On-site
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Pittsburgh, Pennsylvania, United States · Hybrid
$146k–$212k/yr
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Skills: Python, C++, gRPC, SQL, MapReduce
Pittsburgh, Pennsylvania, United States · On-site
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Cranberry Township, Pennsylvania, United States · On-site
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Skills: Commercial Lending, Credit Analysis, Sales Proposals, Portfolio Management, Risk Management
Pittsburgh, Pennsylvania, United States · Hybrid
$130k–$211k/yr
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Pittsburgh, Pennsylvania, United States · Hybrid
$120/hr–$140/hr
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Skills: Psychiatric Evaluation, Treatment Planning, Medication Management, Pediatric Mental Health, Patient Education
Pittsburgh, Pennsylvania, United States · On-site
$69k–$90k/yr
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Pittsburgh, Pennsylvania, United States · On-site
$69k–$153k/yr
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Skills: Data Governance, Data Management, Regulatory Compliance, Data Quality, Data Integrity
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The role involves identifying and mitigating healthcare compliance risks through auditing and monitoring of clinical and billing practices. It requires collaborating with stakeholders to ensure adherence to regulatory requirements and implementing corrective action plans.
Requires a Bachelor's degree with 3 years of experience or a High School Diploma with 7 years of related experience. A professional license (RN/LPN or equivalent) is required, and certifications like CHC or Six Sigma are preferred.
The Healthcare Compliance Auditor Senior I plays a key role in supporting UPMC's compliance and regulatory oversight activities through the identification, assessment, and mitigation of healthcare compliance risks. Leveraging expertise in healthcare operations, reimbursement methodologies, and regulatory requirements, this position conducts auditing and monitoring activities and collaborates with clinical, operational, revenue cycle, and compliance stakeholders to promote adherence to regulatory requirements. This is a full-time position that works Monday through Friday during normal business hours. The role follows a hybrid work model, with a combination of remote work and on-site attendance at UPMC's USX office.
If this sounds like the role for you, apply today!
Responsibilities:
Life Changing Medicine.
UPMC is a world-renowned, nonprofit health care provider and insurer committed to delivering exceptional, people-centered care and community services. Headquartered in Pittsburgh and affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC is shaping the future of health through clinical and technological innovation, research, and education. Dedicated to advancing the well-being of our diverse communities, we provide nearly $2 billion annually in community benefits, more than any other health system in Pennsylvania. Our 100,000 employees — including more than 5,000 physicians — care for patients across more than 40 hospitals and 800 outpatient sites in Pennsylvania, New York, and Maryland, as well as overseas. UPMC Insurance Services covers more than 4 million members, providing the highest-quality care at the most affordable price. To learn more, visit UPMC.com.
Offices: US Steel Tower, 600 Grant Street, Pittsburgh, PA 15219, US
