California Licensed Compliance Consultant

Job Summary

To oversee coding operations and ensure compliance with medical coding standards, the full-time California Licensed Compliance Consultant will apply advanced knowledge of ICD-10-CM coding and risk adjustment methodologies while working remotely from an authorized state.

Key responsibilities

• Supervise and monitor coding operations, ensuring diagnoses are supported by provider documentation and valid medical records
• Analyze operational data to identify performance trends and implement corrective actions for coding inconsistencies
• Lead compliance reporting efforts by summarizing compliance data and developing presentations for management and stakeholders

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 a related field
• Certified Coding Specialist from American Health Information Management Association or equivalent coding certification
• Minimum eight (8) years of experience in health care compliance, operations, audit, finance, or a related field