California Licensed Compliance Consultant

Job Summary

The full-time remote California Licensed Compliance Consultant will supervise and monitor medical coding operations, ensuring compliance with ICD-10-CM coding standards and risk adjustment methodologies while analyzing operational data to identify performance trends and implementing corrective actions.

Key responsibilities:

• Oversee coding operations, ensuring diagnoses are supported by valid medical documentation and compliant with national coding policies
• Conduct compliance investigations and audits, analyzing data and developing corrective action plans for identified issues
• Lead compliance reporting efforts, summarizing audit information and presenting key findings to 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 Health Care Administration, Clinical, Law, Public Health, Business, or a 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