California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage government audit readiness, compliance oversight, and internal quality assurance reviews while working remotely.
Key responsibilities
- Conduct compliance investigations and audits, ensuring adherence to coding policies and identifying potential risks
- Develop compliance reports by evaluating data and summarizing audit findings for management review
- Collaborate with cross-functional teams to enhance coding quality and support continuous improvement initiatives
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, with a minimum of six (6) years in health care compliance or a directly related field
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
Complete Job Description
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