California Licensed Compliance Consultant

Job Summary

Working remotely on a full-time basis, the California Licensed Compliance Consultant IV will independently review medical records to assign ICD-10-CM diagnosis codes, ensure compliance with coding policies, and serve as a subject matter expert in risk adjustment coding.

Key responsibilities:

• Independently review and code inpatient, outpatient, and supplemental medical records in accordance with official guidelines and organizational policies
• Conduct compliance investigations and audits, providing insights and recommendations for strategic compliance initiatives
• Develop and summarize compliance reports, evaluating data and reporting key performance indicators to management

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, plus six (6) years of experience in health care compliance or related areas
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification