Job Description
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
**Candidates residing in the state of New York are highly preferred.**
**Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.
+ Conduct investigations of potential waste, abuse, and fraud
+ Document activity on each case and refer issues to the appropriate party
+ Perform data mining and analysis to detect aberrancies and outliers in claims
+ Develop new queries and reports to detect potential waste, abuse, and fraud
+ Provide case updates on progress of investigations and ...
**Candidates residing in the state of New York are highly preferred.**
**Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.
+ Conduct investigations of potential waste, abuse, and fraud
+ Document activity on each case and refer issues to the appropriate party
+ Perform data mining and analysis to detect aberrancies and outliers in claims
+ Develop new queries and reports to detect potential waste, abuse, and fraud
+ Provide case updates on progress of investigations and ...