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

• Conducts and oversees business-specific projects, ensuring adherence to procedures and policies while coordinating resources to achieve organizational goals
• Leads compliance reporting efforts by evaluating compliance data and audit information, summarizing key findings for management and stakeholders
• Drives regulatory compliance by monitoring changes in regulations and overseeing the implementation of compliance initiatives

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 a minimum of eight (8) years of experience in healthcare compliance or related areas
• Certification as a Coding Specialist from the American Health Information Management Association or as a Certified Risk Adjustment Coder or Certified Professional Coder from the American Academy of Professional Coders