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 audits, develop project workplans, and ensure quality assurance of coding compliance while working remotely.

Key responsibilities

• Oversee business-specific projects by developing work plans, coordinating resources, and promoting adherence to compliance policies
• Lead compliance reporting efforts by evaluating compliance data and summarizing audit information for management
• Conduct compliance investigations by analyzing data, leading interviews, and recommending corrective action plans

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 experience in health care compliance or a directly related field
• Certified Coding Specialist or equivalent certification from recognized organizations