California Licensed Compliance Consultant

Job Summary

To ensure compliance with national coding policies and standards, the full-time California Licensed Compliance Consultant will apply advanced knowledge of medical coding and risk adjustment methodologies while supervising coding operations, reviewing complex scenarios, and leading compliance initiatives remotely.

Key responsibilities:

• Oversee coding operations to ensure accuracy and compliance with documentation standards
• Analyze operational data to identify performance trends and implement corrective actions
• Lead compliance reporting and investigations, summarizing findings for management and stakeholders

Required qualifications:

• Minimum six (6) years of medical coding experience
• Minimum three (3) years of experience in a leadership role
• Bachelor's degree in a related field and eight (8) years of relevant experience in health care compliance or operations
• Certified Coding Specialist or equivalent coding certification
• Proficiency with electronic medical records and coding applications