Healthcare Claims Processor

Type of Requisition: Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

MBI (T2)

Job Family:

SCA

Job Qualifications:

Skills:

CPT Coding, Healthcare Claims, ICD-10 Procedure Coding System

Certifications:

None

Experience:

5 + years of related experience

US Citizenship Required:

No

Job Description:

The World Trade Center Health Program is a limited federal health program administered by the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC) in the U.S. Department of Health and Human Services (HHS). The Program provides no-cost medical monitoring and treatment for certified WTC-related health conditions to those directly affected by the 9/11 attacks in New York, the Pentagon, and in Shanksville, Pennsylvania

Own your opportunity to support medical claims operations that directly impact a federally funded healthcare program. As a Healthcare Claims Processor at GDIT, you’ll apply your claims expertise to ensure accurate, compliant, and timely adjudication while strengthening overall claims integrity and operational performance.

MEANINGFUL WORK AND PERSONAL IMPACT
As a Healthcare Claims Processor, the work you’ll do at GDIT will support the mission of the World Trade Center Health Program’s Third‑Party Administrator operations. You will play a critical role in accurately reviewing and adjudicating professional, facility, complex, and high‑dollar medical claims—ensuring beneficiaries receive fair, timely, and policy‑aligned claim determinations.

● Evaluate, process, and adjudicate medical claims—including professional, facility, complex, and high‑dollar claims—in alignment with program rules, policies, and federal guidelines.
● Apply analytical and problem‑solving skills to interpret program policies, coding rules, and regulatory guidance during claim review.
● Ensure claims are processed within required timeframes and proactively 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, or claim anomalies to support operational reporting and workflow improvements.
● Support internal and external audits by providing documentation, clarifying claim outcomes, and validating compliance with policy and regulatory requirements.
● Demonstrate flexibility in supporting operational ramp‑ups, backlogs, or shifting workload priorities.

WHAT YOU’LL NEED TO SUCCEED
Bring your expertise and commitment to accuracy to GDIT. The Healthcare Claims Processor must have:

● 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 the ability to problem‑solve effectively

GDIT IS YOUR PLACE
At GDIT, the mission is our purpose, and our people are at the center of everything we do.

● Growth: AI-powered career tool that identifies career steps and learning opportunities
● Support: An internal mobility team focused on helping you achieve your career goals
● Rewards: Comprehensive benefits and wellness packages, 401K with company match, competitive pay, and paid time off
● Flexibility: Full-flex work week to own your priorities at work and at home
● Community: Award-winning culture of innovation and a military-friendly workplace

#GDITFedHealthJobs

#WTCJobs

The likely hourly rate for this position is between $17.57 - $19.55. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:

40

Travel Required:

None

Telecommuting Options:

Remote

Work Location:

Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

Our Identify Verification Process:

As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.

About our Work:

We are GDIT. A global technology and professional services company that delivers technology solutions and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-ready capabilities in AI, cloud, cyber and software development.Join our Talent Community to stay up to date on our career opportunities and events at

gdit.com/tc.

Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans