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 collaborate with cross-functional teams to enhance coding quality and compliance, all while working remotely.
Key responsibilities:
- Conduct compliance investigations and audits to ensure adherence to coding standards and regulations
- Develop and evaluate compliance reports, summarizing data and identifying potential risks and remedies
- Collaborate with internal and external stakeholders to implement and monitor compliance initiatives effectively
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 related area
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification
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