Healthcare Claims Processor

General Dynamics Information Technology

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

Posted 10/27/2026full-timeRemote • United StatesMid-LevelSenior💰 $18 - $20 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in processing complex medical claims, applying coding systems such as ICD-10, CPT, and HCPCS, and ensuring compliance with regulatory standards. Strong analytical skills and attention to detail are essential for resolving claim variances and supporting audits.

Highest-signal resume keywords

Medical Claims ProcessingICD-10 CodingCPT CodingHCPCS CodingClaim Denial Resolution

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical TerminologyModifiersBill TypesAdjudication GuidelinesRegulatory GuidanceClaims ReviewClaims ProcessingCompliance ValidationTrend MonitoringRoot Cause Analysis

Soft Skills

Attention to DetailProblem-SolvingCustomer Service MindsetCollaborationAnalytical Thinking

Certifications & Qualifications

MBI (T2) Public Trust

Industry Keywords

Healthcare DeliveryInsurance OperationsHIPAA ComplianceClaims AuditsOperational Ramp-Ups

About the role

Key responsibilities & impact

Evaluate, process, and adjudicate professional, facility, complex, and high-dollar medical claims
Apply program policies, coding rules, and regulatory guidance during claim review
Process claims within required timeframes and address discrepancies
Resolve claim variances and collaborate with cross-functional teams on root causes and corrective actions
Protect member information and uphold HIPAA and program-specific confidentiality requirements
Monitor and report trends, recurring issues, and claim anomalies
Support internal and external audits with documentation, claim-outcome clarification, and compliance validation
Support operational ramp-ups, backlogs, and shifting workload priorities
Support the World Trade Center Health Program’s Third-Party Administrator operations

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
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 requirement
US citizenship not required

Benefits

Comp & perks

Comprehensive medical plan options, some with Health Savings Accounts
Dental plan options
Vision plan
401(k) plan with company match
Full-flex work weeks where possible
Paid time off, including vacation, sick, personal time, holidays, 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
Wellness packages
Competitive pay
Military-friendly workplace