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Licensed Clinical Investigator

Licensed Clinical Investigator

Centene CorporationPompano Beach, FL, United States
20 days ago
Job type
  • Full-time
Job description

A company is looking for a Clinical Investigator in Behavioral Health.Key ResponsibilitiesConduct comprehensive reviews of medical records and documents to support claims and identify potential fraud, waste, and abuseInvestigate provider billing patterns and prepare summaries of findings with recommendations for next stepsCollaborate with investigators to analyze billing activities and recommend changes to prevent future fraudulent practicesRequired Qualifications, Training, and EducationMaster's Degree and 2 years of relevant experience required2+ years of clinical experience with an independent license required2 years of experience in fraud, waste, and abuse investigations requiredBehavioral health license (e.g., LMHC, LCSW, LMFT, LPC, LMHP, LIMHP) requiredCoding certification preferred