California Licensed Compliance Consultant

Job Summary

Serving as a compliance subject matter expert, the full-time remote California Licensed Compliance Consultant will support and manage complex targeted reviews and external audits related to Risk Adjustment Coding, while monitoring quality assurance and summarizing data analytics.

Key Responsibilities

• Conducts and oversees business-specific projects, ensuring adherence to procedures and developing work plans to meet business priorities
• Leads compliance reporting efforts by evaluating compliance data and developing presentations to convey key findings to management
• Manages compliance investigations by coordinating data collection and analysis, leading interviews, and recommending corrective action plans

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 Certified Risk Adjustment Coder from American Academy of Professional Coders OR Certified Professional Coder from American Academy of Professional Coders