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, ensure adherence to coding guidelines, and serve as a subject matter expert on compliance within medical coding, all while working remotely.
Key responsibilities:
- Independently review and assign ICD-10-CM diagnosis codes and hierarchical condition categories for various medical records
- Resolve complex documentation and coding issues, ensuring all coding decisions are defensible and compliant with regulations
- Develop compliance reports and assist in compliance investigations, providing insights and recommendations based on data analysis
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 experience in health care compliance or related fields
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder credentials
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