California Licensed Compliance Consultant
Job Summary
To support compliance initiatives, the full-time California Licensed Compliance Consultant will independently review medical records for accurate coding, ensure adherence to regulations, and serve as a subject matter expert on coding compliance while working remotely.
Key responsibilities
- Independently review and assign ICD-10-CM diagnosis codes and hierarchical condition categories for various medical records
- Conduct compliance investigations and audits, providing insights and recommendations for strategic compliance initiatives
- Develop and summarize compliance reports, highlighting key drivers, liabilities, and performance indicators for 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, along with six (6) years of experience in health care compliance or a related field
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification
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