Clinical Investigator I (special Investigation Unit)
Centene
Nationwide
$56,200.00 - $101,000.00 py
Fully remote
Review medical records
Identify fraud and abuse
Analyze billing patterns
Centene is seeking a Clinical Investigator I for their Special Investigations Unit, a role focused on auditing medical records to identify fraudulent billing practices. The ideal candidate should have nursing or coding credentials, experience in fraud investigations, and a strong background in medical documentation
Job Summary
Centene is transforming the health of our communities, one person at a time.
Perform retrospective and prepayment reviews of medical records to identify potential abuse and fraud and inappropriate billing practices.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
Matching Summary
Match Score: 85
Centene is seeking a Clinical Investigator I for their Special Investigations Unit, a role focused on auditing medical records to identify fraudulent billing practices. The ideal candidate should have nursing or coding credentials, experience in fraud investigations, and a strong background in medical documentation.
Salary
$56,200.00 - $101,000.00 per year
Skills & Requirements
Must-have
review medical records
identify fraud and abuse
analyze billing patterns
recommend next steps
Nice-to-have
provider education
documentation quality focus
Key Requirements
RN or LPN license required
Coding certification required
2+ years clinical experience
Associate's Degree or equivalent experience preferred