California Licensed Compliance Consultant

Job Summary

Serving as a key resource on the Risk Adjustment Coding Compliance team, the full-time California Licensed Compliance Consultant will manage complex reviews and audits, develop project workplans, and ensure compliance with coding policies while working remotely.

Key Responsibilities

• Oversee business-specific projects, ensuring adherence to procedures and developing work plans to meet organizational goals
• Lead compliance reporting efforts by summarizing compliance data and presenting findings to management and stakeholders
• Conduct compliance investigations, coordinating data collection and recommending corrective actions for identified issues

Required Qualifications

• Minimum six (6) years of medical coding experience
• Minimum three (3) years 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 relevant experience
• Certified Coding Specialist or equivalent certification from recognized professional organizations