Claims Specialist

MotivHealth

Claims Specialist handling advanced claim processes and investigations at MotivHealth. Involving collaboration and communication with providers and members to ensure claim quality and accuracy.

Posted 5/21/2026full-timeSouth Jordan • Utah • 🇺🇸 United StatesJuniorWebsite

About the role

Key responsibilities & impact

Load, review and adjudicate complex claims submitted by providers and members electronically and by paper
Manage and perform adjustments, reconsiderations and other advanced claim processes
Consistently exceed processing accuracy and volume standards where appropriate
Research and resolve complicated claims, quality concerns, and other member or provider issues
Participation with external parties regarding Subrogation, Other Payer Liability, High Dollar Claims, Stop Loss and the like
Serve as the point of contact for Claim Processors and Personal Health Assistants claim questions and issues
Identify and explore trends, patterns and issues that require tool or process changes
Maintain compliance, privacy and confidentiality in all documentation, communications and correspondence
Contribute to team wide goals to improve claims processes and integrate additional functions into our operations

Requirements

What you’ll need

At least 6 months experience working as a Claims Processor at MotivHealth, consistently meeting quality and volume standards required
Mastery of all types of claim processes
Medical terminology, CPT, ICD and Revenue Coding expertise
Desire to grow and learn new skills
Respected and trusted by peers and leaders
Excellent interpersonal skills, desire to help others, strong communicators with internal and external parties who have varying knowledge and background, including translating complicated concepts, ensuring understanding and building trust
Proven team player who contributes to building high performing teams
Self-starter who takes initiative, enjoys investigating and solving challenging problems, sees things through to completion and is highly accountable
Clear and confident communication, both written and verbal
Innovator with a strong desire to challenge existing norms related to traditional healthcare and health insurance.

Benefits

Comp & perks

Health insurance
401(k) matching
Flexible working hours
Paid time off
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims processingadjustmentsreconsiderationsmedical terminologyCPT codingICD codingrevenue codingquality assurancedata analysisproblem solving

Soft Skills

interpersonal skillscommunicationteam playerinitiativeaccountabilitytrust buildingadaptabilityinnovationconflict resolutioncollaboration