Healthcare Claims Supervisor

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 lead claims operations that directly support a federally funded healthcare mission. As a Healthcare Claims Supervisor at GDIT, you'll turn operational expertise into mission impact while growing your leadership capabilities and strengthening claims processing performance across a high-volume TPA environment.

As a Healthcare Claims Supervisor, the work you'll do at GDIT will support the mission of a limited-benefit federal healthcare program. You will play a crucial role in ensuring medical claims are reviewed and adjudicated accurately, compliantly, and efficiently - enabling beneficiaries to receive timely and appropriate coverage determinations.

• Supervise day-to-day operations of a medical claims processing team responsible for reviewing, analyzing, and adjudicating professional, facility, and complex claim types.
• Oversee workload distribution, staffing coverage, productivity expectations, and performance monitoring to meet contractual timeliness and accuracy standards.
• Provide coaching, mentoring, and training on claims rules, system changes, Program policy updates, and adjudication procedures to strengthen team expertise.
• Conduct quality reviews, identify error trends, and implement process improvements to enhance accuracy, compliance, and operational efficiency.
• Serve as a subject matter resource for escalations, benefit interpretations, complex claims, and policy questions.
• Ensure proper claim documentation, consistent policy application, and audit-ready recordkeeping across all adjudication actions.
• Collaborate with Medical Policy, Utilization Management, Finance, Provider Services, and Compliance teams to resolve claim discrepancies, coding issues, or benefit concerns.
• Track metrics and prepare operational reports related to productivity, quality, timeliness, inventory aging, and issue trends.
• Support testing and validation of system updates, benefit modifications, policy changes, or new workflows.
• Contribute to hiring, onboarding, performance evaluations, and ongoing development of claims processing staff.
• Ensure compliance with HIPAA and program confidentiality requirements.
• Participate in operational redesign and continuous improvement initiatives to optimize claims processing outcomes.

Bring your expertise and leadership to GDIT. The Healthcare Claims Supervisor must have:

• 5+ years of experience in medical claims processing within a payer, TPA, or government healthcare environment
• 2+ years of lead, senior, or supervisory experience supporting claims operations
• Strong understanding of claims adjudication, reimbursement methodologies, and regulatory requirements
• Knowledge of professional and facility claim formats, modifiers, bill types, and industry-standard adjudication rules
• Proficiency with claims processing systems (Plexis is a plus)
• Strong analytical skills with the ability to interpret claims data, identify root causes, and resolve complex issues
• Excellent communication skills for coaching staff and collaborating across operational teams
• High attention to detail and commitment to accuracy and compliance
• Ability to work independently and lead a remote or distributed team effectively

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

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