California Licensed Compliance Consultant

Job Summary

To ensure compliance with national coding policies, the full-time remote California Licensed Compliance Consultant will apply advanced knowledge of ICD-10-CM coding and risk adjustment methodologies to supervise coding operations, review complex scenarios, and lead compliance initiatives across various healthcare settings.

Key responsibilities

• Oversee coding operations, ensuring diagnoses are supported by valid documentation and conducting audits for quality assurance
• Lead compliance reporting efforts by evaluating compliance data and presenting findings to management and stakeholders
• Manage compliance investigations and initiatives by analyzing regulatory changes and implementing corrective actions as needed

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 with eight (8) years of relevant experience
• Certified Coding Specialist, Certified Risk Adjustment Coder, or Certified Professional Coder certification
• Experience with electronic medical records and coding applications