California Licensed Compliance Consultant

Job Summary

To support the Risk Adjustment Coding Compliance team, the full-time remote California Licensed Compliance Consultant will manage complex targeted reviews and external audits, develop project workplans, and ensure quality assurance of coding compliance while serving as a subject matter expert in medical coding.

Key responsibilities:

• Conducts and oversees business-specific projects, ensuring adherence to procedures and policies while managing 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 changes, assessing current state compliance, 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, along with eight (8) years of relevant experience
• Certified Coding Specialist from the American Health Information Management Association or equivalent coding certification
• Experience in health care compliance, operations, audit, or regulatory fields