California Licensed Compliance Consultant

Job Summary

As a full-time remote California Licensed Compliance Consultant, the candidate will manage complex targeted reviews and external audits related to Risk Adjustment Coding Compliance, develop project workplans, and monitor quality assurance while serving as a subject matter expert in compliance with national coding policies.

Key responsibilities:

• Conduct and oversee business-specific projects, ensuring adherence to procedures and policies while coordinating resources to meet organizational goals
• Lead compliance reporting efforts by evaluating compliance data and presenting key findings to management and stakeholders
• Drive regulatory compliance by monitoring changes, assessing current compliance states, and implementing necessary corrective actions

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 with at least eight (8) years of relevant experience
• Certified Coding Specialist or equivalent certification from recognized organizations