California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage government audit readiness, compliance oversight, and internal quality assurance reviews, while performing coding validation and documentation review in a remote capacity.
Key responsibilities
- Conduct compliance investigations and audits, analyzing data and providing recommendations for corrective actions
- Develop compliance reports summarizing audit information, potential risks, and compliance data for management review
- Collaborate with cross-functional teams to ensure adherence to coding standards and regulatory requirements
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 areas
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification
Complete Job Description
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