California Licensed Compliance Consultant

Job Summary

Working remotely in a full-time capacity, the California Licensed Compliance Consultant will independently review medical records for accurate coding, validate diagnoses, and serve as a compliance subject matter expert while ensuring adherence to national coding policies and procedures.

Key responsibilities

• Independently review and assign ICD-10-CM diagnosis codes and hierarchical condition categories from medical records
• Resolve complex documentation and coding issues, ensuring all coding decisions are defensible and traceable
• Assist with compliance reporting and investigations, monitoring regulatory changes, and supporting the implementation of compliance initiatives

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, along with three (3) years of experience in health care compliance or a related area
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder