We’re looking for an attentive and motivated Payment Integrity Claims Specialist to join our team. They will play a critical role in supporting the accuracy and integrity of claims processing and reimbursement activities. This position is ideal for a detail-oriented individual with experience in healthcare claims, itemized billing, and medical records review. The specialist will ensure compliance with plan benefits and internal policies and collaboration across teams is essential, as this role contributes to the review and final approval process of complex claims.
This is an excellent opportunity to sharpen your analytical skills, deepen your knowledge of healthcare finance, and make a direct impact on ensuring accurate and efficient payments. At MotivHealth, we’re committed to innovation and excellence, offering competitive benefits, bonus opportunities, professional development, and plenty of perks along the way.

• Review and analyze itemized bills and medical records to validate claim accuracy and appropriateness.
• Create detailed summaries outlining how claims were processed.
• Investigate and identify billing discrepancies or potential overpayments.
• Collaborate with internal stakeholders to ensure claims align with plan design and program benefits.
• Assist with processing complex claims and denials, applying knowledge of plan benefits and cost containment strategies.
• Work within spreadsheets to compile data, track reviews, and prepare reports for final approvals.
• Support the Cost Containment/Payment Integrity team on cross-functional projects and process improvements.