California Licensed Compliance Consultant

Job Summary

As a key member of the Risk Adjustment Coding Compliance team, the full-time remote California Licensed Compliance Consultant will manage complex targeted reviews and external audits, develop project workplans, and ensure compliance with national coding policies while monitoring the quality assurance of coding assignments.

Key responsibilities

• Conducts and oversees business-specific projects to promote adherence to procedures and policies while coordinating resources to meet organizational goals
• Leads compliance reporting efforts by summarizing compliance data and developing presentations to convey key findings to management and stakeholders
• Drives regulatory compliance by monitoring regulatory changes and overseeing the implementation of designated compliance efforts

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 eight (8) years of experience in health care compliance or related fields
• Certified Coding Specialist from the American Health Information Management Association OR Certified Risk Adjustment Coder OR Certified Professional Coder from the American Academy of Professional Coders
• Additional equivalent work experience may be substituted for the degree requirement