California Licensed Compliance Consultant

Job Summary

To support compliance initiatives, the full-time California Licensed Compliance Consultant will apply advanced knowledge of ICD-10-CM coding and risk adjustment methodologies while supervising coding operations, ensuring documentation accuracy, and conducting audits remotely.

Key responsibilities

• Supervise and monitor coding operations to ensure compliance with national coding policies and standards
• Conduct audits and present findings to regional staff and senior management, identifying key compliance drivers and risks
• Analyze operational data to identify performance trends and implement corrective actions for coding inconsistencies

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
• Certification as a Coding Specialist from recognized associations (e.g., AHIMA or AAPC)
• Proficiency with electronic medical records and coding applications