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 regulations, and serve as a subject matter expert in risk adjustment coding.

Key responsibilities:

• Independently review and code inpatient, outpatient, and professional medical records in accordance with official guidelines
• Resolve complex documentation and coding issues while documenting rationale and escalating compliance concerns as necessary
• Assist in compliance reporting and investigation efforts, identifying risks and recommending corrective actions

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 relevant experience
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification