California Licensed Compliance Consultant
Job Summary
Working remotely on a full-time basis, the California Licensed Compliance Consultant IV will independently review medical records for coding accuracy, ensure compliance with regulations, and serve as a subject matter expert in medical coding and risk adjustment.
Key responsibilities:
- Independently review and assign ICD-10-CM diagnosis codes to medical records while ensuring compliance with guidelines
- Develop compliance reports and conduct investigations to identify risks and recommend corrective actions
- Collaborate with stakeholders to implement compliance initiatives and monitor adherence to regulatory changes
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 relevant experience
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
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