Senior Healthcare Claims Adjudicator — Remote

General Dynamics Information Technology (GDIT); United States; Remote; USD 37,000 - 41,000; Full time

Benefits offered by this job

Remote work

Competitive benefits

Job summary

General Dynamics Information Technology (GDIT) is seeking a Healthcare Claims Processor to support the World Trade Center Health Program. You will adjudicate medical claims with accuracy and timeliness while ensuring compliance with federal guidelines.

The role requires 5+ years of experience in medical claims, CPT/ICD-10 coding, and a strong attention to detail. The position offers remote work options and a comprehensive benefits package.

Qualifications

• 5+ years of hands-on experience processing medical professional and facility claims, including complex and high-dollar claims.
• Working knowledge of ICD-10, CPT, and HCPCS coding systems.
• Experience with claim denial resolution and appeals workflows.

Responsibilities

• Evaluate, process, and adjudicate medical claims—including professional, facility, complex, and high-dollar claims.
• 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 and report trends, recurring issues, or claim anomalies to support operational reporting and workflow improvements.
• Support internal and external audits by providing documentation and validating compliance with policy and regulatory requirements.

Skills

CPT Coding

Healthcare Claims

ICD-10 Procedure Coding System

Job description

General Dynamics Information Technology (GDIT) is seeking a Healthcare Claims Processor to support the World Trade Center Health Program. You will adjudicate medical claims with accuracy and timeliness while ensuring compliance with federal guidelines.

The role requires 5+ years of experience in medical claims, CPT/ICD-10 coding, and a strong attention to detail. The position offers remote work options and a comprehensive benefits package.