Healthcare Claims Processor – Flexible Hours & Complex Claims

General Dynamics Information Technology, Inc.; Northern (KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Growth opportunities via AI-powered UX

Internal mobility support

Benefits and 401K

Flexible work schedule

Military-friendly workplace

Job summary

General Dynamics Information Technology, Inc. (GDIT) is seeking a Healthcare Claims Processor to support the World Trade Center Health Program's Third-Party Administrator operations.

You will review and adjudicate professional, facility, complex, and high‑dollar medical claims to ensure timely, policy‑aligned determinations. The role requires five years of hands-on claims experience, knowledge of ICD-10/CPT/HCPCS, and strong attention to detail in high‑volume environments.

Qualifications

• Minimum five years processing professional and facility medical claims.
• Knowledge of ICD-10, CPT, and HCPCS coding.
• Experience with modifiers, bill types, and standard adjudication guidelines.
• Detail-oriented with proven accuracy in high-volume processing environments.
• Experience with claim denial resolution and appeals workflows.
• Ability to interpret program policies, payer rules, and federal regulations.

Responsibilities

• Evaluate, process, and adjudicate medical claims—including professional, facility, complex, and high-dollar claims—per program rules.
• Apply analytical and problem-solving skills to interpret program policies, coding rules, and regulatory guidance during claim review.
• Ensure claims are processed within required timeframes and address discrepancies to maintain compliance with timeliness and quality standards.
• Resolve claim variances and collaborate with cross-functional teams to identify root causes and implement corrective actions.
• Protect member information and uphold HIPAA and program-specific confidentiality requirements.
• Monitor trends, recurring issues, or claim anomalies to support operational reporting and workflow improvements.
• Support internal and external audits by providing documentation, clarifying claim outcomes, and validating compliance with policy and regulatory requirements.
• Demonstrate flexibility in supporting operational ramp-ups, backlogs, or shifting workload priorities.

Skills

Medical claims processing

ICD-10/CPT/HCPCS

Regulatory compliance

Attention to detail

Analytical skills

Communication / customer service

Tools

Claims adjudication systems

HIPAA-compliant software

Job description

General Dynamics Information Technology, Inc. (GDIT) is seeking a Healthcare Claims Processor to support the World Trade Center Health Program's Third-Party Administrator operations.

You will review and adjudicate professional, facility, complex, and high‑dollar medical claims to ensure timely, policy‑aligned determinations. The role requires five years of hands-on claims experience, knowledge of ICD-10/CPT/HCPCS, and strong attention to detail in high‑volume environments.