Centene is seeking a Clinical Investigator to audit medical records and identify inappropriate billing practices among its 28 million members
Job Summary
Centene is seeking a Clinical Investigator to audit medical records and identify inappropriate billing practices among its 28 million members.
The ideal candidate will have RN or LPN licensure combined with coding experience to perform retrospective and prepayment reviews of medical records.
This fully remote position offers competitive pay ranging from $56,200 to $101,000 along with comprehensive benefits including health insurance and 401K plans.
Matching Summary
Centene is seeking a Clinical Investigator to audit medical records and identify inappropriate billing practices among its 28 million members.
Salary
Base: $56,200.00 - $101,000.00 per year; Bonus/Equity: Not specified; Benefits: Health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off
Skills & Requirements
Must-have
Audit medical records for billing compliance
Analyze claims data and provider billing patterns
Identify potential fraud and abuse in healthcare
Review corporate and state/federal policy standards
Nice-to-have
Recommend changes to internal policies and procedures
Consult investigators on clinical coding expertise
Develop preventative measures for erroneous practices
Key Requirements
RN, LPN, LPC, LCSW, LMHC, PT, OT, or ST license required