California Licensed Compliance Consultant

Job Summary

Serving as a compliance subject matter expert, the full-time remote California Licensed Compliance Consultant will manage complex targeted reviews and external audits related to Risk Adjustment Coding while ensuring adherence to national coding policies and quality assurance standards.

Key Responsibilities

• Conducts and oversees business-specific projects, developing work plans and coordinating resources to meet organizational goals
• Leads compliance reporting efforts by evaluating compliance data and presenting key findings to management and stakeholders
• Drives regulatory compliance by monitoring changes in regulations and implementing necessary compliance initiatives

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 or equivalent certification from recognized organizations