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 ICD-10-CM coding, ensure compliance with coding policies, and assist with auditing and reporting efforts related to risk adjustment coding.

Key responsibilities:

• Independently review and code inpatient, outpatient, and professional medical records while ensuring compliance with regulations and organizational policies
• Assist with compliance reporting and investigations by analyzing data, identifying risks, and documenting compliance activities
• Provide expertise in coding functions, mentor team members, and support the development of audit result reports

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, plus three (3) years of experience in health care compliance or related fields
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification