Special Investigative Unit Investigator

About This Remote Special Investigative Unit Investigator – Molina Healthcare Role

Microsoft proficiency is hiring for a Remote Special Investigative Unit Investigator – Molina Healthcare position connected to Remote. This Bellencia Career Hub summary translates the original job posting into a structured, easier-to-scan career lead for job seekers comparing remote, hybrid, back-office, healthcare, billing, and administrative opportunities.

The role appears to focus on accurate account work, structured documentation, research, and timely follow-through. Candidates should review the official posting carefully before applying because employer needs, schedules, location rules, and application requirements can change.

Key Responsibilities

Daily Work You May Handle

The core workflow centers on accuracy, research, and keeping accounts or records moving through the correct process. A strong applicant should be comfortable reviewing details, comparing information across systems, updating records, and documenting outcomes in a way that supports clean handoffs between departments.

Minimum Requirements

Education, Experience, and Technical Knowledge

• Molina Healthcare is looking for candidates with:
• At least 2 years of investigative experience in healthcare, or equivalent education and experience
• Valid and unrestricted driver’s license
• Knowledge of fraud investigations and investigative procedures
• Understanding of managed care, Medicare, Medicaid, and Marketplace programs
• Knowledge of claim billing codes, medical terminology, anatomy, and healthcare delivery systems
• Ability to use data analytics to detect fraud, waste, and abuse
• Strong research, critical-thinking, problem-solving, and analytical skills

For this type of role, employers often look for a mix of practical experience, system confidence, and the ability to understand payer, billing, account, or documentation rules. Even when the role is not heavily phone-based, communication still matters because the work may involve coordination with internal teams, management, or partner departments.

Preferred Qualifications

Helpful Background for Stronger Applicants

• Preferred experience includes:
• Medicare, Medicaid, or Marketplace program experience
• Fraud, waste, and abuse investigation experience
• Accredited Health Care Fraud Investigator certification
• Certified Fraud Examiner certification

Phone Level and Work Style

Bellencia phone-level estimate: Low phone. This classification is based on the wording in the pasted posting. Because this is an estimate, applicants who need non-phone or low-phone work should confirm phone expectations during the interview. The posting reads most strongly as Medical Billing work with a focus on written records, account review, payer details, research, and follow-up.

Pay, Schedule, and Location Details

Pay: $19.64 – $42.55 per hour. Schedule: not clearly listed. Job type: Full-time. Location or work arrangement: Remote. Applicants should verify the official application page for the most current pay range, benefits, shift expectations, equipment rules, and state eligibility requirements.

Best-Fit Applicant Profile

This role may be a good match for someone who enjoys detailed, process-driven work and can stay consistent with repetitive but important tasks. It may fit job seekers with experience in medical billing, revenue cycle, accounts receivable, claims, refunds, charge capture, payer research, payment posting, documentation review, insurance eligibility, or healthcare administrative support.

• You are comfortable researching account details and correcting issues before they become larger problems.
• You can follow written procedures and keep documentation clean, accurate, and audit-ready.
• You prefer structured back-office work over sales-driven or heavy call-center duties.
• You can manage confidential information professionally and escalate unclear issues when needed.

Resume Keywords to Consider

Relevant resume keywords may include Remote Special Investigative Unit Investigator – Molina Healthcare, Healthcare, Medical Billing, documentation, account research, workflow queues, Excel, payer requirements, reconciliation. Use only the keywords that honestly match your experience. The strongest applications usually connect past duties directly to the employer’s listed responsibilities.

How to Apply

Use the official application link for this job posting when you are ready to apply. Before submitting, review the required experience, confirm the schedule, and tailor your resume summary and bullet points toward the highest-priority duties in this listing.

Bellencia adds this expanded review so job seekers do not have to decode a long employer posting from scratch. The goal is to make the role easier to compare against your preferred work style, phone tolerance, schedule needs, and long-term career direction.