Compliance Specialist Visa Sponsorship Jobs in Pennsylvania

UPMC Corporate Legal is hiring a Manager, Compliance Review to join our team! This role will work standard business hours Monday through Friday. The position can work fully remote and will need to be within the Central to East time zones.

Under the direction of the Director of Corporate Compliance, the manager is responsible in assisting with the development of compliance programs, and related educational and training materials throughout UPMC. The Manager is also responsible for assisting with all compliance related activities, including HIPAA for the health system, working collaboratively with the UPMC Compliance and Privacy Officers, Patient Business Services, Corporate Legal and Internal Audit departments as necessary. The incumbent will provide vision in planning by setting measurable goals, establishing a monitoring and reporting process regarding all ongoing compliance and ethics activities under the direction of the Chief Compliance Officer. This is a highly visible position that interacts with all UPMC business units at all levels of the organization.

If you have prior experience with compliance and are familiar with revenue cycle, this could be the role for you. Apply today!

Responsibilities:

• Lead and oversee the health system’s Evaluation and Management (E/M) compliance program, including auditing and monitoring of E/M coding, documentation, billing, and reimbursement practices.
• Monitor E/M coding and billing trends and regulatory guidance to identify potential compliance risks, recommend corrective actions, and support consistent application of E/M requirements across the health system.
• Serve as a subject matter expert for E/M compliance, partnering with Compliance, Coding, Revenue Cycle, clinical departments, and other stakeholders to provide guidance, education, and support related to E/M documentation and billing requirements.
• Effectively communicate and support the UPMC mission and values to employees at all levels of the health system/insurance services division.
• Assist with analysis, problem solving and investigations.
• Lead, plan, develop, and conduct education and training activities related to compliance and ethics activities or topics.
• Coordinate and facilitate activities in order to achieve compliance with government established deadlines.
• Develop presentations and educational materials for individuals at all levels of the health system/Insurance Services Divisions and to provide education and compliance regulatory updates.
• Establish monitoring mechanisms and conduct routine audits of the compliance/ethics program.
• Assist with establishing policies and procedures in support of compliance and ethics activities.

BASIC QUALIFICATIONS:

• The Manager of Corporate Compliance must possess a professional level degree, BS Degree preferred, or equivalent work experience and a professional certification.
• A minimum of five (5) years' work experience with related activities in management and compliance related areas such as Regulatory Review, Medical Records, Registration, Billing, Investigation, and Reporting is also required.
• Current professional coding certification (e.g., CPC, CCS-P, or equivalent) required.
• Experience within revenue cycle preferred.
• Experience in a hospital preferred.
• Knowledge of Microsoft Office applications is required along with well-developed analytical, problem-solving and interpersonal skills.

Licensure, Certifications, and Clearances:

• Act 34
• Current professional coding certification (e.g., CPC, CCS-P, or equivalent) required.

UPMC is an Equal Opportunity Employer/Disability/Veteran