Minimum Qualifications:

Minimum one (1) year of experience in Referral Services, Claims Membership, Medical Claims, Contracting with Medical Providers, Referral Processing, Authorization/Referral Claims Administration or a directly related field.

Bachelors degree in General Studies, Nursing, Public Health, Social Work, Medicare, Computer Science, Health Care Administration, Business, Health Plan Administration, Insurance Administration, Finance, Pharmacy, or related field AND minimum one (1) year of experience in Claims Consulting, Referral Claims Administration, Customer Service, Automated Claims Systems, Administrative Services, or a directly related field OR Minimum four (4) years of experience in referral processing, authorization/referral claims administration, administrative services, customer service or a directly related field.

Additional Requirements:

Knowledge, Skills, and Abilities (KSAs): Business Operations; Compliance Management; Data Entry; Data Stewardship; Customer Experience; Computer Literacy; Insurance Coding; Insurance

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