Healthcare Senior 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: At GDIT, people are our differentiator. We are seeking Healthcare Senior Claims Processors to support day-to-day medical claims operations within a Third-Party Administrator (TPA) environment serving the federally funded, limited-benefit World Trade Center Health Program. In this role, you will review, analyze, and adjudicate professional, facility, complex, and high-dollar claims in accordance with program guidelines, regulatory requirements, and internal quality standards. You will apply strong critical-thinking skills, provide advanced technical guidance to claims staff, mentor processors, maintain strict confidentiality, mentor peers, participate in audits, and contribute to continuous improvement activities that strengthen overall claims operations performance. The Senior Claims Processor will also ensure consistent interpretation of claim policies; and support operational readiness, training, and workflow optimization. Responsibilities : Evaluate, process, and adjudicate professional, facility, complex, and high-dollar claims in alignment with program policies and federal guidelines. Interpret and apply