California Licensed Compliance Consultant

Job Summary

Serving as a compliance subject matter expert, the full-time remote California Licensed Compliance Consultant will independently review medical records for coding accuracy, ensure compliance with national coding policies, and assist with auditing and reporting efforts related to risk adjustment coding.

Key responsibilities

• Independently review inpatient and outpatient medical records to assign ICD-10-CM diagnosis codes and validate documentation
• Assist with compliance reporting and investigation efforts, identifying potential risks and recommending corrective actions
• Support the development and implementation of compliance standards, policies, and training initiatives

Required qualifications

• Minimum two (2) years of medical coding experience
• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field, along with three (3) years of experience in health care compliance or related areas
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder