Clinical Investigator I (Special Investigation Unit) at Centene

You're an experienced professional with at least two years of clinical experience and a coding certification from an accredited organization like AAPC or AHIMA, or a relevant clinical license such as RN, LPN, or LCSW. Centene is looking for a Clinical Investigator I to work remotely in various states. This role involves auditing medical records to identify improper billing practices. You might be a good fit if you... * Perform retrospective and prepayment reviews of medical records. * Analyze provider billing patterns using claims data and medical records. * Identify potential fraud, abuse, and inappropriate billing practices. * Recommend preventative measures and changes to policies.