California Licensed Compliance Consultant
Job Summary
To support the Risk Adjustment Coding Compliance team, the full-time California Licensed Compliance Consultant will manage complex targeted reviews and external audits, develop project workplans, and ensure quality assurance for coding compliance, all while working remotely.
Key Responsibilities
- Oversee business-specific projects by developing work plans, coordinating resources, and promoting adherence to compliance procedures
- Conduct compliance activities by partnering with stakeholders, analyzing regulations, and executing strategic compliance initiatives
- Lead compliance reporting efforts by summarizing data, identifying compliance drivers, and presenting 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
- Certified Coding Specialist from American Health Information Management Association or equivalent coding certification
- Experience in health care compliance, operations, audit, or regulatory affairs
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