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

• Oversee business-specific projects, ensuring adherence to procedures and policies while coordinating resources to meet organizational goals
• Lead compliance reporting efforts by summarizing data and audit information, and developing presentations to convey findings to management
• Conduct compliance investigations by analyzing data, leading interviews, and recommending corrective action plans for identified issues

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 from the American Health Information Management Association, or Certified Risk Adjustment Coder, or Certified Professional Coder from the American Academy of Professional Coders
• Experience in health care compliance, operations, audit, finance, or regulatory development