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 performing coding validation and collaborating with cross-functional teams to enhance coding quality and drive continuous improvement in a remote setting.
Key responsibilities
- Conduct compliance investigations and audits to ensure adherence to coding standards and regulations
- Develop compliance reports by evaluating data and summarizing findings for management review
- Coordinate compliance efforts by identifying requirements, assessing current compliance states, and implementing corrective actions
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 experience in health care compliance or related areas
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification
Complete Job Description
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