General Dynamics Information Technology (GDIT) oferă servicii de consultanță, modernizare digitală și dezvoltare de aplicații pentru organizații guvernamentale și din domeniul apărării. Activitatea companiei acoperă inteligența artificială, cloud computing, securitatea cibernetică, calculul de înaltă performanță și tehnologiile cuantice, precum și programe esențiale pentru misiuni din domeniile logisticii și gestionării lanțului de aprovizionare, informațiilor și securității interne. Compania activează, de asemenea, în consultanță, asistență medicală și logistică, iar eforturile sale de recrutare pun accent pe echipe diverse și pe bunăstarea angajaților. Posturile din cadrul GDIT pot fi potrivite pentru profesioniști interesați să aplice tehnologii emergente la provocări complexe din sectorul public și din domeniul securității naționale.
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.
Descriere
- 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
Cerințe
- 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
Beneficii
- 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