General Dynamics Information Technology (GDIT) सरकारी और रक्षा संगठनों को परामर्श, डिजिटल आधुनिकीकरण और एप्लिकेशन सेवाएँ प्रदान करती है। इसका कार्य कृत्रिम बुद्धिमत्ता, क्लाउड कंप्यूटिंग, साइबर सुरक्षा, उच्च-प्रदर्शन कंप्यूटिंग और क्वांटम तकनीकों के साथ-साथ लॉजिस्टिक्स और आपूर्ति शृंखला प्रबंधन, खुफिया और मातृभूमि सुरक्षा से जुड़े महत्वपूर्ण कार्यक्रमों तक फैला हुआ है। कंपनी परामर्श, स्वास्थ्य सेवा और लॉजिस्टिक्स क्षेत्रों में भी काम करती है, तथा इसकी भर्ती पहलों में विविध टीमों और कर्मचारियों के कल्याण पर जोर दिया जाता है। GDIT की भूमिकाएँ उन पेशेवरों के लिए उपयुक्त हो सकती हैं जो उभरती तकनीकों को जटिल सार्वजनिक क्षेत्र और राष्ट्रीय सुरक्षा चुनौतियों पर लागू करने में रुचि रखते हैं।
Healthcare Claims Processor - Remote, United States
Process and adjudicate complex medical claims for GDIT’s federally funded World Trade Center Health Program. Apply coding expertise and regulatory knowledge to deliver accurate, compliant, and timely determinations.
विवरण
- Review and adjudicate professional, facility, complex, and high-dollar medical claims
- Use analytical and problem-solving skills to interpret program policies, coding requirements, and regulatory guidance
- Complete claims within required timeframes and resolve discrepancies to meet quality and compliance standards
- Investigate claim variances with cross-functional teams, determine root causes, and implement corrective actions
- Safeguard member information in accordance with HIPAA and program-specific confidentiality requirements
- Track and report trends, recurring issues, and claim anomalies to inform operational reporting and workflow improvements
- Assist internal and external audits by supplying documentation, explaining claim outcomes, and validating compliance
- Help manage operational ramp-ups, backlogs, and changing workload priorities
- Support GDIT’s Third-Party Administrator operations for the World Trade Center Health Program
आवश्यकताएँ
- At least five years of hands-on experience processing professional and facility medical claims, including complex and high-dollar claims
- Working knowledge of ICD-10, CPT, and HCPCS coding systems
- Proven experience applying modifiers, bill types, and standard adjudication guidelines
- Strong understanding of medical terminology, healthcare delivery, and insurance operations
- Workers’ compensation experience is a plus
- Exceptional attention to detail and demonstrated accuracy in high-volume processing environments
- Ability to interpret and apply program policies, payer rules, and federal regulations
- Willingness to complete ongoing training and stay current with coding standards, regulatory changes, and system updates
- Experience resolving claim denials and managing appeals workflows
- Strong analytical and customer-service orientation with effective problem-solving skills
- MBI (T2) public trust or other required clearance
- U.S. citizenship is not required
लाभ
- Comprehensive medical plan options, including plans with Health Savings Accounts
- Dental plan options
- Vision plan options
- 401(k) plan with pre-tax and post-tax contribution options plus a company match
- Full-flex work weeks where available
- Paid leave programs covering vacation, sick, personal time, holidays, parental, military, bereavement, and jury duty leave
- Typically 15 paid leave days per calendar year
- 10 paid holidays each year
- Up to 160 hours of paid family leave during a rolling 12-month period for eligible employees
- Short- and long-term disability coverage
- Life insurance
- Accidental death and dismemberment insurance
- Personal accident insurance
- Critical illness insurance
- Business travel and accident insurance
- AI-powered career tools that identify career steps and learning opportunities
- An internal mobility team that supports employee career goals
- Wellness packages
- Competitive pay
- An award-winning culture of innovation
- Military-friendly workplace