California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will oversee compliance activities, conduct coding validation, and partner with various teams to enhance coding quality and ensure regulatory compliance, all while working remotely.
Key responsibilities
- Conducts compliance activities and oversees business-specific projects to promote adherence to regulations and improve operational efficiency
- Leads compliance reporting efforts by analyzing data, summarizing audit information, and presenting key findings to management
- Drives regulatory compliance by monitoring changes and implementing necessary adjustments to compliance standards and procedures
Required qualifications
- Minimum six (6) years of medical coding experience
- Minimum three (3) years in a leadership role
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field with eight (8) years of relevant experience
- Certified Coding Specialist or equivalent certification from recognized organizations
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