Claims Processing Lead – Wtchp Tpa

General Dynamics IT (GDIT)

Remote, US
Base: $97,968 - $100,050; bonus/equity: not specif...
Fully remote
Cms 1500 claim forms
Healthcare claims processing
Health care systems
Supervise a team of claims processors, providing daily technical guidance, performance feedback, and training on WTC-specific adjudication rules

Job Summary

  • Supervise a team of claims processors, providing daily technical guidance, performance feedback, and training on WTC-specific adjudication rules.
  • Implement and monitor rigorous Quality Assurance (QA) protocols to ensure 99%+ accuracy in claim payments and adherence to HIPAA and federal regulations.
  • GDIT offers a 401K with company match, comprehensive health and wellness packages, and professional scientific growth opportunities.

Matching Summary

Supervise a team of claims processors, providing daily technical guidance, performance feedback, and training on WTC-specific adjudication rules.

Salary

Base: $97,968 - $100,050; Bonus/Equity: Not specified; Benefits: Comprehensive health and wellness packages, 401K with company match, paid time off

Skills & Requirements

Must-have

  • CMS 1500 Claim Forms
  • Healthcare Claims Processing
  • Health Care Systems
  • ICD-10 Procedure Coding System
  • WTC Health Program regulations

Nice-to-have

  • Prior WTC Health Program experience
  • Strong analytical mindset
  • Professional scientific growth opportunities

Key Requirements

  • 5+ years of related experience
  • 2+ years in a lead, supervisory, or senior auditing capacity
  • Mastery of claims platforms experience
  • Advanced Microsoft Excel skills
  • Comprehensive understanding of CMS-1500 and UB-04 forms
  • ICD-10/CPT coding
  • Federal reimbursement methodologies
  • Experience managing a claims team
  • Bachelor of Arts or Bachelor of Science degree

Work Rights

Not specified

Tailored Resume

Cover Letter