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General Dynamics Information Technology
3.9
Healthcare TPA Member Services Processing Analyst
Remote
$55K - $75K (Employer provided)
Best Places to Work
Perform data entry and record updates within member services tools—including digital mail center systems, entry portal, and intelligent document processing……
12d
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Easy Apply
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2d
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Senior Application Engineer
Pensacola, FL
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Excellent analytical, problem-solving, troubleshooting, written communication, and verbal communication skills, with the ability to explain complex technical……
2d
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Easy Apply
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Deloitte
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Cyber Zscaler Network Security Engineer / Senior Consultant, Strategy, Growth, and Transformation
Costa Mesa, CA
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3.5
Actuary – Financial Projection Modeling (Modeling Center of Excellence)
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In addition to generous vacation time, paid holidays, and flexible holidays, MassMutual offers 'take care' time to care for yourself or someone you love—whether……
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General Dynamics Information Technology
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General Dynamics Information Technology
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General Dynamics Information Technology

3.9

Healthcare TPA Member Services Processing Analyst

Remote

$55K - $75K (Employer provided)

Is your resume a good match?

Use AI to find out how well the skills on your resume fit this job description.

Clearance Level

None

REQ#: RQ223955

Public Trust: MBI (T2)

Requisition Type: Regular

Your Impact

Own your opportunity to work alongside federal civilian agencies. Make an impact by providing services that help the government ensure the well being and support of U.S. citizens.

Job Description

Summary:
The Member Services Process Analyst supports day‑to‑day operations within a Third‑Party Administrator (TPA) healthcare environment by reviewing, validating, and processing member applications, certifications, transfers, appeals, designated representative appointments, documentation, and service requests. This role plays a critical part in ensuring members experience a smooth and efficient program experience, maintaining accuracy, compliance, and service quality across all processing activities. The specialist works closely with supervisors and cross‑functional teams, utilizing member services systems and tools to support timely and compliant workflow execution.
Responsibilities:

Process enrollment applications, documentation, certifications, transfers, appeals, and designated representative appointments and updates in accordance with program policies, SOPs, and federal requirements.
Review member-submitted materials for completeness, accuracy, and eligibility, ensuring all required data is properly captured and validated.
Analyze documentation submitted with the application and assess if the submission meets the requirements of program enrollment.
Perform data entry and record updates within member services tools—including digital mail center systems, entry portal, and intelligent document processing platforms—ensuring timely routing and processing of member documentation.
Maintain accurate and high-quality case notes, documentation, and processing records for program review, compliance, and audit readiness.
Communicate professionally with members, providers, and internal stakeholders regarding documentation requirements, missing information, or status updates.
Escalate complex or ambiguous cases to the Member Services Processing Supervisor for review and guidance.
Adhere to HIPAA and program privacy requirements when handling PII/PHI.
Support quality assurance activities by identifying errors, trends, or potential improvements and providing feedback to leadership.
Participate in cross‑training and process updates to ensure efficient support across multiple workflows, including enrollment, record updates, appeals routing, and member correspondence.
Contribute to continuous improvement efforts by providing insight into workflow challenges, system issues, or enhancement opportunities.

Core Competencies

Accuracy and Quality
Service Orientation
Problem Solving
Accountability
Process Discipline
Adaptability and Learning Agility
Team Collaboration

Required Qualifications

Strong written and verbal communication skills.
Ability to follow detailed procedures, meet deadlines, and adapt to changing priorities.
Strong attention to detail with the ability to analyze documentation to determine if it meets program requirements.
High School Diploma or equivalent.
1–3 years of experience in processing, administrative support, data entry, customer service, or a related operational role.

Preferred Qualifications

Background supporting federal health programs or healthcare operations.
Experience working with intelligent document processing tools, member service portals, or customer support platforms such as ServiceNow or CXone.

GDIT IS YOUR PLACE:

Full-flex work week to own your priorities at work and at home.
401K with company match.
Comprehensive health and wellness packages.
Internal mobility team dedicated to helping you own your career.
Professional growth opportunities including paid education and certifications.
Cutting-edge technology you can learn from.
Rest and recharge with paid vacation and holidays.

#GDITFedHealthJobs

Work Requirements

Years of Experience

5 + years of related experience

may vary based on technical training, certification(s), or degree

Certification

Travel Required

Less than 10%

Salary and Benefit Information

The likely hourly rate for this position is between $55,250.00 - $74,750.00. 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.

Our Identity 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

See company reviews

Base pay range

The minimum salary is $55K and the max salary is $75K.

$55K – $75K/yr (Employer provided)

$65K

/yr Median

Remote

If an employer includes a salary or salary range on their job, we display it as "Employer Provided". If a job has no salary data, Glassdoor displays a "Glassdoor Estimate" if available. To learn more about "Glassdoor Estimates," see our FAQ page.

Working here doesn’t have to be a secret

3.9

Recommend to a friend
Approve of CEO
CEO: Amy Gilliland
1,602 Ratings

General Dynamics Information Technology

3.9

Healthcare TPA Member Services Processing Analyst

Remote

$55K - $75K (Employer provided)

General Dynamics Information Technology

3.9

Healthcare TPA Member Services Processing Analyst

Remote

$55K - $75K (Employer provided)

Is your resume a good match?

Use AI to find out how well the skills on your resume fit this job description.

Clearance Level

None

REQ#: RQ223955

Public Trust: MBI (T2)

Requisition Type: Regular

Your Impact

Own your opportunity to work alongside federal civilian agencies. Make an impact by providing services that help the government ensure the well being and support of U.S. citizens.

Job Description

Process enrollment applications, documentation, certifications, transfers, appeals, and designated representative appointments and updates in accordance with program policies, SOPs, and federal requirements.
Review member-submitted materials for completeness, accuracy, and eligibility, ensuring all required data is properly captured and validated.
Analyze documentation submitted with the application and assess if the submission meets the requirements of program enrollment.
Perform data entry and record updates within member services tools—including digital mail center systems, entry portal, and intelligent document processing platforms—ensuring timely routing and processing of member documentation.
Maintain accurate and high-quality case notes, documentation, and processing records for program review, compliance, and audit readiness.
Communicate professionally with members, providers, and internal stakeholders regarding documentation requirements, missing information, or status updates.
Escalate complex or ambiguous cases to the Member Services Processing Supervisor for review and guidance.
Adhere to HIPAA and program privacy requirements when handling PII/PHI.
Support quality assurance activities by identifying errors, trends, or potential improvements and providing feedback to leadership.
Participate in cross‑training and process updates to ensure efficient support across multiple workflows, including enrollment, record updates, appeals routing, and member correspondence.
Contribute to continuous improvement efforts by providing insight into workflow challenges, system issues, or enhancement opportunities.

Core Competencies

Accuracy and Quality
Service Orientation
Problem Solving
Accountability
Process Discipline
Adaptability and Learning Agility
Team Collaboration

Required Qualifications

Strong written and verbal communication skills.
Ability to follow detailed procedures, meet deadlines, and adapt to changing priorities.
Strong attention to detail with the ability to analyze documentation to determine if it meets program requirements.
High School Diploma or equivalent.
1–3 years of experience in processing, administrative support, data entry, customer service, or a related operational role.

Preferred Qualifications

Background supporting federal health programs or healthcare operations.
Experience working with intelligent document processing tools, member service portals, or customer support platforms such as ServiceNow or CXone.

GDIT IS YOUR PLACE:

Full-flex work week to own your priorities at work and at home.
401K with company match.
Comprehensive health and wellness packages.
Internal mobility team dedicated to helping you own your career.
Professional growth opportunities including paid education and certifications.
Cutting-edge technology you can learn from.
Rest and recharge with paid vacation and holidays.

#GDITFedHealthJobs

Work Requirements

Years of Experience

5 + years of related experience

may vary based on technical training, certification(s), or degree

Certification

Travel Required

Less than 10%

Salary and Benefit Information

Our Identity Verification Process

About Our Work

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

See company reviews

Base pay range

The minimum salary is $55K and the max salary is $75K.

$55K – $75K/yr (Employer provided)

$65K

/yr Median

Remote

Working here doesn’t have to be a secret

3.9

Recommend to a friend
Approve of CEO
CEO: Amy Gilliland
1,602 Ratings

7,681 Virtual cloud professional jobs in United States

REQ#: RQ223955

Public Trust: MBI (T2)

Requisition Type: Regular

Your Impact

Job Description

Work Requirements

Salary and Benefit Information

Our Identity Verification Process

About Our Work

Base pay range

Working here doesn’t have to be a secret

REQ#: RQ223955

Public Trust: MBI (T2)

Requisition Type: Regular

Your Impact

Job Description

Work Requirements

Salary and Benefit Information

Our Identity Verification Process

About Our Work

Base pay range

Working here doesn’t have to be a secret