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 to supervise coding operations, ensure compliance with documentation standards, and conduct audits remotely.

Key Responsibilities

• Supervise and monitor coding operations, ensuring diagnoses are supported by valid medical record evidence
• Analyze operational data to identify performance trends and implement corrective actions for coding inconsistencies
• Lead compliance reporting efforts, summarizing audit information and presenting key findings 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 Health Care Administration, Clinical, Law, Public Health, Business, or related field, with eight (8) years of relevant experience
• Certification as a Coding Specialist or Risk Adjustment Coder from recognized associations
• Proficiency with electronic medical records and coding applications