Member Services Processing Specialist

General Dynamics Information Technology

. Review, validate, and process member applications, certifications, transfers, appeals, designated representative appointments, documentation, and service requests .

Posted 9/22/2026full-timeRemote • United StatesJunior💰 $72,877 - $98,599 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in processing member applications and documentation while ensuring compliance with HIPAA regulations. Strong analytical skills and attention to detail are essential for evaluating documentation and improving operational efficiency.

Highest-signal resume keywords

Document ProcessingHIPAA ComplianceAnalytical SkillsCustomer ServiceProcess Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data EntryApplication ProcessingDocumentation EvaluationOperational AnalyticsQuality Assurance

Soft Skills

Written CommunicationVerbal CommunicationAttention to DetailAdaptabilityProblem Solving

Tools & Technologies

Intelligent Document Processing ToolsMember Service PortalsCustomer Support PlatformsDigital Mail Center SystemsIntake/Entry Portals

Industry Keywords

Federal Health ProgramsHealthcare OperationsPIIPHISOP

About the role

Key responsibilities & impact

Review, validate, and process member applications, certifications, transfers, appeals, designated representative appointments, documentation, and service requests
Own end-to-end processing of enrollment applications, certifications, transfers, appeals, designated representative appointments, and member record updates
Review member-submitted materials for completeness, accuracy, and eligibility
Determine follow-up actions and coordinate with members, providers, and internal stakeholders
Evaluate documentation against program enrollment and certification criteria
Identify edge cases and recommend resolution paths
Use digital mail center systems, intake/entry portals, and intelligent document processing platforms to triage, route, and process documentation
Maintain case notes and processing records for audits, compliance reviews, and operational analytics
Partner with supervisors and cross-functional teams to resolve complex scenarios and improve workflow efficiency
Monitor backlog, turnaround time, accuracy rate, and other operational metrics
Contribute to corrective actions and continuous improvement initiatives
Escalate ambiguous or high-risk cases with clear documentation and decision rationale
Support quality assurance by identifying trends and error drivers
Participate in cross-training for enrollment, record updates, appeals routing, designated representative processing, and member correspondence
Apply policies and SOPs with discretion, identify exceptions, and propose resolution options
Prioritize work using risk-based criteria and service levels
Recommend process improvements and contribute to SOP updates
Participate in validation and testing when new procedures or tools are introduced

Requirements

What you’ll need

High School Diploma or equivalent
1–3 years of experience in processing, administrative support, data entry, customer service, or related operations
Strong written and verbal communication skills
Ability to follow detailed procedures, meet deadlines, and adapt to changing priorities
Demonstrated analytical skills with close attention to detail
Ability to evaluate documentation against defined program requirements
Background supporting federal health programs or healthcare operations preferred
Experience with intelligent document processing tools, member service portals, or customer support platforms preferred
Exposure to HIPAA-regulated environments and familiarity with handling PII/PHI preferred
No US citizenship required
Must handle PII/PHI in accordance with HIPAA and program privacy requirements
Must follow security and access controls

Benefits

Comp & perks

Full-flex work week to own your priorities at work and at home
401K with company match
Comprehensive health and wellness packages
Internal mobility team dedicated to helping you own your career
Professional growth opportunities including paid education and certifications
Cutting-edge technology you can learn from
Paid vacation and holidays
Medical plan options, including plans with Health Savings Accounts
Dental plan options
Vision plan options
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
Identity verification process using advanced biometrics and artificial intelligence