California Licensed Compliance Consultant
Job Summary
To support compliance initiatives, the full-time California Licensed Compliance Consultant will independently review medical records for coding accuracy, validate diagnoses, and resolve complex coding issues while working remotely.
Key responsibilities:
- Independently review and assign ICD-10-CM diagnosis codes and hierarchical condition categories for various medical records
- Serve as a compliance subject matter expert, assisting with coding questions and auditing across all lines of business
- Develop compliance reports and conduct investigations to ensure adherence to regulatory standards and organizational policies
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 relevant experience
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
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