High-Volume Health Claims Processor — HIPAA/ERISA Expert

MotivHealth Insurance Company; South Jordan (UT); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health insurance

HSA contribution

Wellness program

Retirement plan match 3%

Career development

PTO 15 days + 10 holidays

Job summary

MotivHealth Insurance Company is seeking a detail-oriented Claims Processor to review, adjudicate, and resolve a high volume of provider and member claims across all lines of business.

You will work within Level-Funded, TPA, and ASO arrangements, ensuring claims are processed accurately, on time, and in compliance with plan documents, employer requirements, and regulatory standards. The role offers competitive benefits and opportunities for growth.

Qualifications

• 2+ years of experience processing high-volume health insurance claims.
• Solid understanding of medical terminology and coding standards.
• Experience with ERISA and HIPAA regulations.
• Proven ability to meet tight turnaround times in fast-paced environments.

Responsibilities

• 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.

Skills

Claims processing

Medical coding standards

ERISA/HIPAA knowledge

Analytical thinking

Turnaround time

MS Office

Claims processing systems

Education

High school diploma or equivalent

Tools

MS Office

Claims processing platforms

Job description

MotivHealth Insurance Company is seeking a detail-oriented Claims Processor to review, adjudicate, and resolve a high volume of provider and member claims across all lines of business.

You will work within Level-Funded, TPA, and ASO arrangements, ensuring claims are processed accurately, on time, and in compliance with plan documents, employer requirements, and regulatory standards. The role offers competitive benefits and opportunities for growth.