Member Services Processing Specialist

About this role

Type of Requisition:
RegularClearance Level Must Currently Possess:
NoneClearance Level Must Be Able to Obtain:
NonePublic Trust/Other Required:
NoneJob Family:
SCAJob Qualifications:
Skills:
Collaboration, Customer Problem Solving, Customer Service, Microsoft Applications, MultitaskingCertifications:
NoneExperience:
1 + years of related experienceUS Citizenship Required:
NoJob Description:
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.

Summary:
The Member Services Processing Specialist 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

• High School Diploma or equivalent.

• 1–3 years of experience in processing, administrative support, data entry, customer service, or a related operational role.

• 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.

• Location: Remote
Clearance: Must be able to obtain and maintain a Public Trust
Travel: 0-10%

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

#GDITWTCJobs

The likely hourly rate for this position is between $22.97 - $31.07. 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:
40Travel Required:
Less than 10%Telecommuting Options:
RemoteWork Location:
Any Location / RemoteAdditional 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…