Top 31 Fraud Jobs in Mississippi

Senior Compliance Investigator
Centene —Mississippi
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
10d
Billing and Coding Associate
Derick Dermatology PLLC —Mississippi
- $18 an hour
- Full-time
- Remote
- High school diploma or GED
- Medical-Surgical
- Computer skills
- Paid training
- Work from home
Quick Apply
Surveillance Investigator I - Entry Level
Command Investigations, LLC —Southaven, MS
- $20 - $25 an hour
- 8 hour shift
- Microsoft Word
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Surveillance Investigator
Allied Universal® Compliance and Investigations —Tupelo, MS
- Weekends as needed
- Microsoft Word
- Military
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
8d
Surveillance Investigator
Frasco Inc —Jackson, MS
- $20 - $26 an hour
- Part-time
- Clean driving record
- Military
- Writing skills
- Paid training
- Mileage reimbursement
SIU Claims Investigator
Lemieux & Associates LLC —Hattiesburg, MS
- $25 - $32 an hour
- Part-time
- Bilingual
- Computer literacy
- Mid-level
- Flexible schedule
Quick Apply
Surveillance Investigator II - Experienced
Command Investigations, LLC —Southaven, MS
- $25 - $30 an hour
- 8 hour shift
- Microsoft Word
- Clean driving record
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Healthcare Fraud Investigator
Contact Government Services, LLC —Oxford, MS
- Full-time
- Bachelor's degree
- Typing
- Senior level
- Health insurance
- Dental insurance
Quick Apply
SIU - Experienced Field Investigator - Part-Time
Command Investigations, LLC —Jackson, MS
- $28 - $32 an hour
- Overtime
- Bilingual
- Microsoft Outlook
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Grand Bank - Enterprise Compliance Analyst
Continental Finance Company —Hattiesburg, MS
- Full-time
- Research
- Mid-level
- Microsoft Office
- Profit sharing
- Disability insurance
Quick Apply
5d
Field Investigator - McComb, MS (PM)
United Recovery & Remarketing —McComb, MS
- Full-time
- Clean driving record
- Ability to climb stairs
- Ability to lift 50 pounds
Quick Apply
Field Investigator - Meridian, MS
United Recovery & Remarketing —Marion, MS
- Full-time
- Clean driving record
- Ability to climb stairs
- Ability to lift 50 pounds
Quick Apply
Licensed Covert Surveillance Investigator - Part Time - Tupelo, MS
Meridian Investigative Group, Inc —Tupelo, MS
- $20 - $30 an hour
- Extended hours
- Microsoft Word
- Computer literacy
- Writing skills
As Needed Field Investigator- Hattiesburg, MS
J T Becker & Co Inc —Hattiesburg, MS
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
As Needed Field Investigator- Tupelo, MS
J T Becker & Co Inc —Tupelo, MS
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
As Needed Field Investigator- Jackson, MS
J T Becker & Co Inc —Jackson, MS
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
Quality Inspector (1st Shift)
Jabil Circuit —Byhalia, MS
- Full-time
- Mid-level
- High school diploma or GED
- Manufacturing
14d
Quality Inspector (Weekend 1st Shift)
Jabil Circuit —Byhalia, MS
- Full-time
- Mid-level
- High school diploma or GED
- Manufacturing
14d
Licensed Covert Surveillance Investigator - Part Time - Jackson, MS
Meridian Investigative Group, Inc —Jackson, MS
- $20 - $30 an hour
- Extended hours
- Microsoft Word
- Computer literacy
- Writing skills
Director of Internal Audit
Mississippi Valley State University —Itta Bena, MS
- Management
- CPA
- 5 years

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Senior Compliance Investigator

Centene -
Mississippi

Apply Now

Job Details

Full-time
$70,100 - $126,200 a year
10 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Investigations regulatory compliance
Medical law
State healthcare regulations
Investigating compliance violations
Risk & issue management

Full Job Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Under the general direction of the VP of Compliance Investigations this position assists with the development, implementation, and continuous monitoring of an enterprise-wide Compliance Investigations Program and leads the Company's Compliance Investigations for all Business Units, Health Plans, and Corporate functions. Leads and oversees compliance and ethics investigations, facilitates and leads meetings with business management and cross-functional stakeholders, and prepares, reviews, and analyzes internal and external reporting. Supports the Director, Ethics & Investigations in the day-to-day operations of the Compliance Investigations Unit (CIU).

Leads and conducts compliance and ethics investigations across all business units and health plans, including but not limited to assessment of allegations, review of relevant documents, witness interviews, analysis of facts, root cause analysis, and preparation of investigation reports with recommended remedial or disciplinary actions.
Independently evaluates and assesses allegations to determine applicable criteria, including federal and state regulations, the Centene Code of Conduct, and internal policies, procedures, and standards that are alleged to have been violated.
Adheres to Compliance Investigation workplans and protocols and conducts investigations in compliance with established protocols and timelines.
Provides weekly case summaries and adheres to established minimum case review quotas to ensure timely progression and resolution of the investigative caseload.
Ensures all investigative findings are clearly tied to applicable company policies (e.g., Code of Conduct), federal and state regulations, and to maintain regulatory defensibility and support appropriate remediation.
Provides timely reports, both orally and in writing, to the Director of Ethics & Investigations and/or senior management regarding the status and outcomes of investigations.
Thoroughly documents, organizes, and reviews case files within centralized case management systems (e.g., Archer) in accordance with Company policy and CIU protocols.
Collaborates cross-functionally with other departments, including Legal, People Relations, SIU, Privacy, Finance, and Business Operations on investigations and the investigative process.
Prepares and analyzes departmental metrics, including investigation KPIs, case aging, and trending data, and makes recommendations accordingly.
Prepares presentations and presents findings to departmental and business management, executive leadership, and other stakeholders as needed.
Identifies risks, interprets investigation results, and recommends and communicates remedial actions to mitigate future potential risks.
Performs follow-up to ensure remedial/disciplinary measures are implemented appropriately and timely, including tracking remediation activities through case management systems.
Assists with various projects as assigned by the Director of Ethics & Investigations or the VP of Compliance Investigations.
Performs other duties as assigned.
Complies with all policies and standards.

Education/Experience:

A Bachelor's Degree in Related Field or Associates with 5 years of applicable experience, or a High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree, required.
4+ years of experience in investigations, auditing and risk analysis required.
1+ year of experience in reading, analyzing and interpreting State and Federal laws, rules and regulations required.

Preferred Qualifications:

Managed care or health insurance company experience preferred.
Experience with compliance case management systems (e.g., Archer, Navex) preferred.
Demonstrated experience conducting ethics and compliance investigations in a regulated healthcare environment preferred.
Experience collaborating with cross-functional teams including Legal, People Relations, SIU, and Privacy preferred.

Licenses and Certifications:

Certified Fraud Examiner (CFE) preferred.
Certified Compliance & Ethics Professional (CCEP) or Certified Healthcare Compliance (CHC) preferred.

Pay Range: $70,100.00 - $126,200.00 per year

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

Apply Now

Refine Your Search

fraud jobs in mississippi

Senior Compliance Investigator

Billing and Coding Associate

Surveillance Investigator I - Entry Level

Surveillance Investigator

Surveillance Investigator

SIU Claims Investigator

Surveillance Investigator II - Experienced

Healthcare Fraud Investigator

SIU - Experienced Field Investigator - Part-Time

Grand Bank - Enterprise Compliance Analyst

Field Investigator - McComb, MS (PM)

Field Investigator - Meridian, MS

Licensed Covert Surveillance Investigator - Part Time - Tupelo, MS

As Needed Field Investigator- Hattiesburg, MS

As Needed Field Investigator- Tupelo, MS

As Needed Field Investigator- Jackson, MS

Quality Inspector (1st Shift)

Quality Inspector (Weekend 1st Shift)

Licensed Covert Surveillance Investigator - Part Time - Jackson, MS

Director of Internal Audit

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