[Skip to main content](#main-content) [OpenNash Jobs](https://jobs.opennash.com/) [Hiring report](/reports/hiring/) · [All Centene jobs](https://jobs.opennash.com/companies/centene/) · [Search jobs](/search/) Centene · Remote-MO # Clinical Investigator I (Special Investigation Unit) Remote-MO Remote Healthcare & Clinical Listed on Centene’s official careers site. Posted September 24, 2026. Check that it is still open and apply there. [Apply on Centene’s careers site →](https://centene.wd5.myworkdayjobs.com/centene_external/job/Remote-MO/Clinical-Investigator-I--Special-Investigation-Unit-_1660463) [OpenNash Jobs](https://jobs.opennash.com/) / [Centene](https://jobs.opennash.com/companies/centene/) / Clinical Investigator I (Special Investigation Unit) ## Job description ### Position Purpose Audit medical records to identify inappropriate billing practices and recommend next steps through extensive review of claims data, medical records, corporate policy, state/federal policy, and practice standards. ### Key Details Preferred qualifications include coding certification, nurse coding experience, and experience with CPT coding. - Perform retrospective and prepayment reviews of medical records to identify potential abuse and fraud and inappropriate billing practices - Investigate, analyze, and identify provider billing patterns to recommend payment based on medical records, claim history, billing codes, regulatory and state guidelines, and policies - Prepare summary of findings and recommend next steps for providers - Identify preventative measures and recommend changes to internal policies and procedures and/or provider practices to prevent future fraudulent and erroneous practices - Consult investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities - Performs other duties as assigned. Complies with all policies and standards. ### Education/Experience Associate's Degree related field or equivalent experience preferred 2+ years related clinical experience in the field of obtained license required Provider education preferred Licenses/Certifications: Coding certification from an accredited organization (American Academy of Professional Coders or American Health Information Management Association), RN, LPC, LPN, LCSW, LMHC, PT, OT, or ST or related license. required At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday. ### 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. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act ## At a glance - Posted by the employer: Sep 24, 2026 - First seen by OpenNash: Oct 11, 2026 - Last checked: Oct 18, 2026 - Listed for: 24 days - Location: Remote-MO - Work arrangement: Remote[Apply on Centene’s careers site →](https://centene.wd5.myworkdayjobs.com/centene_external/job/Remote-MO/Clinical-Investigator-I--Special-Investigation-Unit-_1660463) ## More jobs at Centene ### [Clinical Investigator (Behavioral Health)](https://jobs.opennash.com/companies/centene/jobs/293a876915bd335e0e37/) Remote-MO ### [Compliance Oversight Specialist (Non Clinical)](https://jobs.opennash.com/companies/centene/jobs/a452862821b567ab3938/) Remote-MO ### [Contracts & Regulatory Intern (Healthcare Law Student Summer 2027)](https://jobs.opennash.com/companies/centene/jobs/f02096af55821486733c/) Remote-MO ### [Director, Clinical Training](https://jobs.opennash.com/companies/centene/jobs/d06d89cb01db3c486df8/) Remote-MO ### [Manager, Clinical Quality Training](https://jobs.opennash.com/companies/centene/jobs/8e9dcbb2c424a433c5a0/) Remote-MO ## Similar jobs at other companies ### [Investigations:Investigator - Centralised Investigation](https://jobs.opennash.com/companies/axis-bank/jobs/9243fc1bcc7864dad7f1/) Axis Bank · Mumbai ### [Investigations:Senior Investigator - Corporate Lending Investigation](https://jobs.opennash.com/companies/axis-bank/jobs/8a69bb5258e641d5638e/) Axis Bank · Mumbai ### [Special Investigation Unit (SIU) Manager](https://jobs.opennash.com/companies/cvs-health/jobs/b92ddaca401e6a193e23/) CVS Health ### [Senior Investigator, Special Investigations Unit (Aetna SIU)](https://jobs.opennash.com/companies/cvs-health/jobs/90259e2735c8db757508/) CVS Health ### [Employee Relations Investigator, Worldwide Operations Centralized Investigation](https://jobs.opennash.com/companies/amazon/jobs/798ff1e703399e544ab5/) Amazon · BR, SP, Sao Paulo OpenNash lists jobs from employers’ own careers sites and does not handle applications. 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