Thanks for all the suggestions, turned out we had NPROC set too high on Packages.
This server had the most significant reduction (from load spikes of 120+ to a load average under 1), surprisingly enough it was still functioning pretty well under those crazy load spikes, high iowait (between 60-95%) was causing the load:
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The following commands were helpful in narrowing the problem down in case anyone else runs into this:
Monitor CPU / RAM usage:
top -c
Input/output disk statistics by process / thread:
iotop
Virtual memory statistics:
vmstat
Monitor system input / output statistics:
iostat
View the processes when a load spike hits, ultimately for us there were a bunch of D state processes causing this:
ps -e v