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
- Conducts coding validation and documentation reviews to ensure regulatory compliance and coding integrity
- Partners with operational, clinical, and compliance teams to identify risks and improve coding quality
- Leads compliance reporting efforts by evaluating compliance data and developing presentations for management
Required qualifications
- Minimum six (6) years of medical coding experience
- Minimum three (3) years of experience in a leadership role
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field, or equivalent experience
- Certified Coding Specialist, Certified Risk Adjustment Coder, or Certified Professional Coder certification
- Experience in health care compliance, operations, audit, or regulatory policy development
Complete Job Description
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