California Licensed Compliance Consultant

Job Summary

Serving as a key consultant on 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 of coding compliance while working remotely.

Key responsibilities

• Conducts and oversees business-specific projects, promoting adherence to procedures and policies while coordinating resources to meet organizational goals
• Leads compliance reporting efforts by evaluating compliance data and developing presentations to convey findings to management and stakeholders
• Drives regulatory compliance by monitoring regulatory changes and implementing designated compliance efforts across the organization

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 relevant experience
• Certified Coding Specialist or equivalent certification from recognized professional organizations