Healthcare Claims Processor

General Dynamics Information Technology

. Evaluate, process, and adjudicate professional, facility, complex, and high-dollar medical claims .

Posted 10/7/2026full-timeRemote • United StatesMid-LevelSenior💰 $18 - $20 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in processing complex medical claims, including a strong understanding of ICD-10, CPT, and HCPCS coding systems. Capable of applying analytical skills to resolve claim variances and ensure compliance with regulatory standards.

Highest-signal resume keywords

Medical Claims ProcessingICD-10, CPT, HCPCS CodingClaim Denial ResolutionAnalytical Problem-SolvingAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Claims ProcessingICD-10 CodingCPT CodingHCPCS CodingModifiersBill TypesAdjudication GuidelinesClaim Denial ResolutionRegulatory ComplianceHealthcare Delivery

Soft Skills

Analytical MindsetCustomer ServiceProblem-Solving

Certifications & Qualifications

MBI (T2) Public Trust

Industry Keywords

Medical TerminologyInsurance OperationsWorkers’ CompensationOperational ReportingWorkflow ImprovementsHIPAA Compliance

About the role

Key responsibilities & impact

Evaluate, process, and adjudicate professional, facility, complex, and high-dollar medical claims
Apply analytical and problem-solving skills to interpret program policies, coding rules, and regulatory guidance
Process claims 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, and claim anomalies to support operational reporting and workflow improvements
Support internal and external audits by providing documentation, clarifying claim outcomes, and validating compliance
Support operational ramp-ups, backlogs, and shifting workload priorities
Support the World Trade Center Health Program’s Third-Party Administrator operations at GDIT

Requirements

What you’ll need

Minimum 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
Demonstrated experience with modifiers, bill types, and standard adjudication guidelines
Strong understanding of medical terminology, healthcare delivery, and insurance operations
Workers’ compensation experience is a plus
High attention to detail with proven accuracy in high-volume processing environments
Ability to interpret and apply program policies, payer rules, and federal regulations
Commitment to ongoing training and staying current on coding standards, regulatory changes, and system updates
Experience with claim denial resolution and appeals workflows
Strong analytical and customer-service mindset with effective problem-solving ability
MBI (T2) public trust/other required
US citizenship is not required

Benefits

Comp & perks

Comprehensive medical plan options, some with Health Savings Accounts
Dental plan options
Vision plan options
401(k) plan with ability to contribute pre-tax and post-tax dollars and receive a company match
Full-flex work weeks where possible
Paid time off plans including vacation, sick, personal time, holidays, paid parental, military, bereavement, and jury duty leave
Typically 15 days of paid leave per calendar year
10 paid holidays per year
Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees
Short- and long-term disability benefits
Life insurance
Accidental death and dismemberment insurance
Personal accident insurance
Critical illness insurance
Business travel and accident insurance
AI-powered career tool identifying career steps and learning opportunities
Internal mobility team supporting career goals
Wellness packages
Competitive pay
Award-winning culture of innovation
Military-friendly workplace