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 coding, validate documentation, and serve as a subject matter expert on compliance in medical coding for risk adjustment.
Key responsibilities:
- Independently review and assign ICD-10-CM diagnosis codes and hierarchical condition categories based on medical records
- Resolve complex coding issues and document coding rationale while ensuring compliance with national coding policies
- Assist in compliance reporting and investigations by analyzing data and identifying potential risks
Required qualifications:
- Minimum two (2) years of medical coding experience
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field, along with three (3) years of relevant experience
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification
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