Lead Certified Coder - QA & Operational Integrity

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 90,000 - 120,000; Full time

Job summary

UPMC Health Plan seeks a Certified Coder Quality Assurance Operational Integrity Lead for a full-time hybrid role in Pittsburgh. You will lead QA professionals across ISD, guiding reviews to ensure operational integrity, risk mitigation, and adherence to initiatives and goals.

Candidates must hold a CPC Certification and demonstrate leadership, mentorship, and the ability to manage complex auditing projects and staff workloads.

Qualifications

• Must be a CPC certified coder with strong QA/review experience.
• Leadership and mentoring capabilities for QA staff.

Responsibilities

• Lead QA and operational integrity assessments across ISD portfolio.
• Coordinate workgroups and initiatives to drive results and efficiency.
• Provide training and guidance to staff; oversee day-to-day activities and workload distribution.
• Maintain policies and ensure compliance with departmental procedures and quality standards.

Education

CPC Certification

Certified Coder

Job description

UPMC Health Plan seeks a Certified Coder Quality Assurance Operational Integrity Lead for a full-time hybrid role in Pittsburgh. You will lead QA professionals across ISD, guiding reviews to ensure operational integrity, risk mitigation, and adherence to initiatives and goals.

Candidates must hold a CPC Certification and demonstrate leadership, mentorship, and the ability to manage complex auditing projects and staff workloads.