California Licensed Compliance Consultant
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Job Summary
Working remotely in a full-time capacity, the California Licensed Compliance Consultant will independently review medical records for accurate ICD-10-CM coding, ensure compliance with coding policies, and serve as a subject matter expert in risk adjustment coding.
Key responsibilities
- Independently review inpatient and outpatient medical records to assign appropriate diagnosis codes and hierarchical condition categories
- Assist with compliance reporting and investigations by analyzing data and identifying potential risks or misalignments
- Support the development of compliance standards and training while monitoring adherence to regulatory changes
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 a minimum of three (3) years in health care compliance or related areas
- Certification as a Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
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