California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage government audit readiness, compliance oversight, and internal quality assurance reviews while working remotely.
Key responsibilities
- Conduct compliance investigations and develop corrective action plans based on audit findings
- Evaluate compliance data and generate reports for management on key compliance drivers and performance indicators
- Collaborate with cross-functional teams to ensure adherence to regulatory standards and improve coding quality
Required qualifications
- Minimum four (4) years of medical coding experience
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field, along with six (6) years of relevant experience
- Certification as a Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
Complete Job Description
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