Remote Healthcare Fraud Investigator

Centene Corp.; Texas; Remote; USD 56,000 - 101,000; Full time

Job summary

Centene Corp. is hiring a SIU Investigator to conduct fraud, waste, and abuse investigations remotely in Texas. You will review referrals, claims data, medical records, and provider information to identify misconduct and support case resolution.

Prepare investigative reports and collaborate with compliance, legal, and external agencies as needed. The role requires 2+ years in healthcare investigations, a bachelor's degree in a related field, and certifications preferred.

Qualifications

• 2+ years in fraud, waste, and abuse investigations or related field.
• Experience analyzing healthcare claims, records, or financial information for case development.
• Licensing/certifications preferred (AHFI, CFE, CPC, CPMA).

Responsibilities

• Conduct FWA investigations using referrals, data, medical records, and interviews.
• Document findings, prepare reports, and refer cases to internal or external bodies.
• Coordinate with compliance, legal, and provider teams to support action and recovery.
• Monitor emerging fraud schemes and assist with audits and regulatory responses.

Skills

FWA investigations

Regulatory compliance

Analytical thinking

Investigative reporting

Education

Bachelor's degree in Business, Criminal Justice, Healthcare Administration, Public Health, or related field

Job description

Centene Corp. is hiring a SIU Investigator to conduct fraud, waste, and abuse investigations remotely in Texas. You will review referrals, claims data, medical records, and provider information to identify misconduct and support case resolution.

Prepare investigative reports and collaborate with compliance, legal, and external agencies as needed. The role requires 2+ years in healthcare investigations, a bachelor's degree in a related field, and certifications preferred.