California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will ensure government audit readiness, conduct coding validation and documentation reviews, and collaborate with various teams to enhance coding quality and compliance in a remote work environment.
Key responsibilities
- Conduct compliance investigations and develop corrective action plans based on findings
- Evaluate compliance data and create reports summarizing key compliance drivers and potential risks
- Collaborate with stakeholders to implement compliance initiatives and monitor adherence to regulations
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 related areas
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification
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