California Licensed Compliance Consultant

Job Summary

To support compliance initiatives, the full-time remote California Licensed Compliance Consultant will apply advanced knowledge of medical coding and risk adjustment methodologies to supervise coding operations, ensure compliance with documentation standards, and analyze operational data for performance trends.

Key responsibilities

• Supervise and monitor coding operations to ensure compliance with ICD-10-CM coding and risk adjustment standards
• Conduct compliance activities, including audits and investigations, while partnering with internal and external stakeholders
• Lead compliance reporting efforts by evaluating data, summarizing audit findings, and presenting key insights to management

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 a minimum of eight (8) years of experience in health care compliance or related areas
• Certified Coding Specialist or equivalent coding certification
• Proficiency with electronic medical records and coding applications