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 to supervise coding operations, ensure documentation accuracy, and conduct compliance audits remotely.

Key responsibilities

• Supervise and monitor coding operations to ensure compliance with national coding policies and clinical documentation standards
• Analyze operational data to identify trends and implement corrective actions for coding inconsistencies and documentation concerns
• Lead compliance reporting and investigations by evaluating data, summarizing findings, and developing presentations for management

Required qualifications

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