Remote Healthcare Claims Supervisor — Lead Adjudication Ops

General Dynamics Information Technology, Inc.; Fairfax (VA); Remote; USD 51,000 - 69,000; Full time

Benefits offered by this job

Growth opportunities

Internal mobility

Competitive pay & benefits

Flexible schedule

Military-friendly culture

Job summary

General Dynamics Information Technology, Inc. seeks a Healthcare Claims Supervisor to lead a high-volume claims processing team supporting a federally funded health program.

You will oversee review, adjudication, and timely processing of professional, facility, and complex claims, ensuring accuracy, compliance, and audit-ready documentation. You will coach staff, monitor performance, and collaborate with Medical Policy, Utilization Management, Finance, and Compliance to resolve issues.

Qualifications

• 5+ years of experience in medical claims processing within a payer, TPA, or government healthcare environment
• 2+ years of lead, senior, or supervisory experience supporting claims operations
• Strong understanding of claims adjudication, reimbursement methodologies, and regulatory requirements
• Knowledge of professional and facility claim formats, modifiers, bill types, and industry-standard adjudication rules
• Proficiency with claims processing systems (Plexis is a plus)
• Strong analytical skills with the ability to interpret claims data, identify root causes, and resolve complex issues
• Excellent communication skills for coaching staff and collaborating across operational teams
• High attention to detail and commitment to accuracy and compliance

Responsibilities

• Supervise day-to-day operations of a medical claims processing team responsible for reviewing, analyzing, and adjudicating professional, facility, and complex claim types
• Oversee workload distribution, staffing coverage, productivity expectations, and performance monitoring to meet contractual timeliness and accuracy standards
• Provide coaching, mentoring, and training on claims rules, system changes, Program policy updates, and adjudication procedures to strengthen team expertise
• Conduct quality reviews, identify error trends, and implement process improvements to enhance accuracy, compliance, and operational efficiency
• Serve as a subject matter resource for escalations, benefit interpretations, complex claims, and policy questions
• Ensure proper claim documentation, consistent policy application, and audit-ready recordkeeping across all adjudication actions
• Collaborate with Medical Policy, Utilization Management, Finance, Provider Services, and Compliance teams to resolve claim discrepancies, coding issues, or benefit concerns
• Track metrics and prepare operational reports related to productivity, quality, timeliness, inventory aging, and issue trends
• Support testing and validation of system updates, benefit modifications, policy changes, or new workflows
• Contribute to hiring, onboarding, performance evaluations, and ongoing development of claims processing staff
• Ensure compliance with HIPAA and program confidentiality requirements
• Participate in operational redesign and continuous improvement initiatives to optimize claims processing outcomes

Skills

Claims adjudication

Claims processing

Healthcare claims

Tools

Plexis

Job description

General Dynamics Information Technology, Inc. seeks a Healthcare Claims Supervisor to lead a high-volume claims processing team supporting a federally funded health program.

You will oversee review, adjudication, and timely processing of professional, facility, and complex claims, ensuring accuracy, compliance, and audit-ready documentation. You will coach staff, monitor performance, and collaborate with Medical Policy, Utilization Management, Finance, and Compliance to resolve issues.