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Claims Processor

MotivHealth • South Jordan, UT, US • published 2026-10-06 01:33:33.820228

Description

We’re looking for a detail\-oriented, self\-motivated Claims Processor to join our team. In this role, you’ll review, adjudicate, and resolve a high volume of provider and member claims across all lines of business. Working within Level\-Funded, TPA (Third Party Administrator), and ASO (Administrative Services Only) arrangements, you’ll ensure claims are processed accurately, on time, and in compliance with plan documents, employer requirements, and regulatory standards. **HERE’S WHAT YOU’LL DO IN THIS ROLE:** * Process a large daily volume of claims with accuracy and efficiency. * Review and apply plan designs, stop\-loss provisions, and benefit rules. * Verify member eligibility and coverage across multiple employer groups. * Apply knowledge of CPT, ICD\-10, HCPCS, and other coding standards. * Resolve discrepancies, errors, and incomplete claim submissions. * Communicate with providers, members, and employer groups to gather information. * Maintain compliance with HIPAA, ERISA, and self\-funded plan regulations. * Support audits, reporting, and process improvements. **HERE’S WHAT WE ARE LOOKING FOR:** * High school diploma or equivalent * 2\+ years of experience processing high\...

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