California Licensed Compliance Consultant

Job Summary

Working remotely in a full-time capacity, the California Licensed Compliance Consultant will independently review medical records to assign ICD-10-CM diagnosis codes, ensure compliance with coding policies, and assist with auditing and reporting efforts related to risk adjustment coding.

Key responsibilities:

• Independently review and validate medical records for accurate coding and compliance with regulations
• Assist in compliance reporting by monitoring data, identifying risks, and summarizing findings for senior team members
• Support compliance investigations by collecting data, analyzing discrepancies, and developing corrective action plans

Required qualifications:

• Minimum two (2) years of medical coding experience
• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field, plus three (3) years of experience in health care compliance or a directly related field
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder from relevant professional organizations