California Licensed Compliance Consultant

Job Summary

To support compliance initiatives, the full-time California Licensed Compliance Consultant will apply advanced knowledge of medical coding and risk adjustment methodologies, supervise coding operations, and ensure adherence to documentation standards while working remotely.

Key responsibilities:

• Supervise and monitor coding operations to ensure compliance with ICD-10-CM coding and risk adjustment requirements
• Conduct compliance investigations and audits, analyzing data and recommending corrective actions as needed
• Lead compliance reporting efforts by summarizing compliance data and presenting findings to management and stakeholders

Required qualifications:

• Minimum six (6) years of medical coding experience
• Minimum three (3) years in a leadership role
• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field with eight (8) years of relevant experience
• Certified Coding Specialist, Certified Risk Adjustment Coder, or Certified Professional Coder certification required
• Proficiency with electronic medical records and coding applications