Payment Integrity Supervisor, Mid-Level

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Job Summary:

MotivHealth is a growing insurance company that takes an innovative approach to creating and administering customized insurance plans. They are seeking a committed Payment Integrity Supervisor to lead efforts in maximizing cost-saving strategies and oversee a team responsible for claims review and vendor coordination.

Responsibilities:

• Supervise daily operations of the cost containment team, bill review specialists, coordinators, and vendor liaisons.

• Oversee the application of cost containment strategies such as PPO repricing, out-of-network negotiations, and clinical/utilization reviews.

• Collaborate with claims, legal, and provider relations teams to ensure consistent application of cost-saving protocols.

• Manage relationships with external vendors (e.g., bill review, CCR, and other insurance carriers as well as Stop Loss Provider) to ensure service quality and contractual compliance.

• Analyze claims data to identify trends, anomalies, and opportunities for additional savings.

• Ensure adherence to federal and state regulations, including ERISA, HIPAA, and workers’ compensation statutes.

• Develop and maintain SOPs and training materials for cost containment processes.

Qualifications:

Required:

• 3–5 years of experience in cost containment, claims management, or healthcare finance within a TPA or insurance carrier setting.

• 1–2 years of supervisory or team leadership experience.

• Strong understanding of medical billing, coding (ICD, CPT, HCPCS), and reimbursement methodologies.

• Familiarity with claims adjudication systems and cost containment platforms.

• Excellent communication, negotiation, and analytical skills.

• Proficiency in data analysis tools (Excel, reports) and claims system.

Company:

MotivHealth is an insurance company which provides health insurance, hsa, hsa health insurance, and health savings account services. Founded in 2015, the company is headquartered in South Jordan, Utah, USA, with a team of 51-200 employees. The company is currently Growth Stage.