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 for coding compliance in a remote setting.

Key responsibilities

• Conducts and oversees business-specific projects, ensuring adherence to procedures and policies while managing resources and timelines
• Leads compliance reporting efforts by summarizing compliance data and presenting key findings to management and stakeholders
• Drives regulatory compliance by monitoring regulatory changes and implementing necessary compliance efforts across the organization

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, Certified Risk Adjustment Coder, or Certified Professional Coder certification
• Experience in health care compliance, operations, audit, finance, or regulatory development