FAQs
What is the primary purpose of the Special Investigation Unit Investigator position?
The primary purpose of the position is to investigate allegations of potential healthcare fraud and abuse activity, assisting in planning, organizing, and executing claims investigations or audits.
What qualifications are required for this position?
A Bachelor’s Degree in Business, Criminal Justice, Healthcare, or a related field, or equivalent experience, along with 1+ years of medical claim investigation, audit, analysis, or fraud investigation experience is required.
Is travel required for this role?
Yes, approximately 10% travel may be required for this role.
What type of experience is preferred for applicants?
Experience in medical claim investigation, medical claim audit, medical claim analysis, or fraud investigation is preferred, along with knowledge of Microsoft Applications, medical coding, and terminology.
What does the work environment look like for this position?
Centene offers a flexible approach to work, with options for remote, hybrid, field, or office work schedules.
What benefits are included in the compensation package?
The compensation package includes competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and additional incentives.
How does Centene approach diversity in hiring?
Centene is an equal opportunity employer committed to diversity and values the differences in all individuals. All qualified applicants will receive consideration for employment without regard to various protected characteristics.
Are applicants with arrest or conviction records considered for employment?
Yes, qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
What type of investigations will the Special Investigation Unit Investigator conduct?
The investigator will conduct investigations of potential waste, abuse, and fraud in healthcare claims.
What is included in the investigative process for this role?
The process includes documenting activity on each case, performing data mining and analysis, preparing reports on findings, and coordinating with Health Plans for recommendations and further actions.