• CRP Compliance Analyst

    UPMC (Pittsburgh, PA)


    Purpose:

    Under the direction of the Chief Audit & Compliance Officer and Compliance Manager, the Compliance Analyst is primarily responsible for supporting the mission and goals of the Office of Ethics and Compliance Department. Assistance and support may include research and analysis of regulations, monitoring and compiling reports of compliance activity and behavior identified through compliance reporting mechanisms, and conducting investigations and audits in support of the various compliance programs. The Compliance Analyst is expected to contribute to the implementation and success of ongoing departmental goals as defined in the Annual Compliance Work-plan.

    Responsibilities:

    + Oversees Compliance Analyst I staff, as required

    + Perform chart reviews to assess compliance with coding and billing regulations.

    + Extract and compile reimbursement data for regulatory analysis.

    + Facilitate investigations, as assigned.

    + Possess understanding of health care terminology and industry risk

    + Monitor and report on Compliance Helpline (hotline), Exit Interviews, Conflict of Interest related matters and other miscellaneous compliance projects as assigned.

    + Assist in developing, maintaining and exhibiting departmental professionalism and reputation.

    + Facilitate and help analyze conflict of interest reporting.

    + Help to enhance and maintain internal and external websites.

    + Assist with collection and monitoring of Compliance Watch results.

    + Assist with monitoring and reporting of conflict management plans.

    + Assist in planning, developing and creating educational and training materials related to specific compliance topics.

    + Effectively communicate and support the values of UPMC to employees at all levels of the organization.

    + Assist in establishing and maintaining policies, procedures and tools to support compliance activities.

    + Contribute to ongoing departmental goals.

    + Assist the Chief Audit and Compliance Officer and Compliance Managers on special projects, as assigned.

    + Bachelor's degree and two years of compliance, legal, regulatory, financial, audit, or business experience, preferably in a health care setting OR

    + Associate's degree and four years of compliance, legal, regulatory, financial, audit, or business experience, preferably in a health care setting OR

    + Coding Certificate or completion of approved coding program and six years of compliance, legal, regulatory, financial, audit, or business experience, preferably in a health care setting OR

    + Enrollment in or completion of Graduate level degree and completion of a UPMC Compliance ExternshipLicensure, Certifications, and Clearances:

    + Act 34

     

    UPMC is an Equal Opportunity Employer/Disability/Veteran