Transfer and Referral Specialist
About The Position
We are so glad you are interested in joining Sutter Health! Position Overview: Reviews confidential clinical information and provides personalized referrals to individuals or physicians/clinics requiring specialty services from a contracted medical group, hospital, or third-party payor. Facilitates referrals to appropriate Sutter facility, program or affiliated and aligned specialists. Full Time & Part Time Roles Are Available – variable shifts and 8 or 12 hour shifts locations Sacramento + Novato Additional Requirements: Full Time & Part Time Roles Are Available – variable shifts and 8 or 12 hour shifts locations Sacramento + Novato EDUCATION: Equivalent experience will be accepted in lieu of the required degree or diploma. Bachelor's: Business and/or Healthcare Administration, or related field. TYPICAL EXPERIENCE: 2 years of recent relevant experience. SKILLS AND KNOWLEDGE: Working knowledge of managed care requirements and processes. Knowledge of system, affiliate and community resources, and third-party payers (e.g., PPO, HMO, Medicare, insurance plans). knowledge of insurance authorization process and HIPPA requirements. Familiar with medical and managed care terminologies. Understanding of disease process to assess referral requests and appropriate level/provider of care required. Ability to define issues, collect data, establish facts and draw valid conclusions. Displays a customer service focus in all decisions and actions. Ability to communicate through verbal and written means, and to present information to a variety of audiences.. Organization skills to effectively manage and/or re-prioritize activities and projects to meet deadlines while maintaining a high degree of responsiveness. Ability to interact and maintain effective working relationships with those contacted in the performance of required duties. Demonstrates respect for cultural and linguistic differences and promotes an inclusive work environment. Demonstrates initiative in providing feedback/input to improve workflow/processes. Ability to work effectively in a dynamic and fast-paced environment with changing business priorities. Ability to maintain and work discreetly with confidential and sensitive information. Ability to use essential applications and/or databases associated with the role’s duties and responsibilities. Working at Sutter Health Sutter Health values and supports the unique talents and strengths that each employee brings to our organization. As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.
Requirements
- Bachelor's: Business and/or Healthcare Administration, or related field or equivalent experience
- 2 years of recent relevant experience.
- Working knowledge of managed care requirements and processes.
- Knowledge of system, affiliate and community resources, and third-party payers (e.g., PPO, HMO, Medicare, insurance plans).
- knowledge of insurance authorization process and HIPPA requirements.
- Familiar with medical and managed care terminologies.
- Understanding of disease process to assess referral requests and appropriate level/provider of care required.
- Ability to define issues, collect data, establish facts and draw valid conclusions.
- Displays a customer service focus in all decisions and actions.
- Ability to communicate through verbal and written means, and to present information to a variety of audiences.
- Organization skills to effectively manage and/or re-prioritize activities and projects to meet deadlines while maintaining a high degree of responsiveness.
- Ability to interact and maintain effective working relationships with those contacted in the performance of required duties.
- Demonstrates respect for cultural and linguistic differences and promotes an inclusive work environment.
- Demonstrates initiative in providing feedback/input to improve workflow/processes.
- Ability to work effectively in a dynamic and fast-paced environment with changing business priorities.
- Ability to maintain and work discreetly with confidential and sensitive information.
- Ability to use essential applications and/or databases associated with the role’s duties and responsibilities.
Responsibilities
- Reviews confidential clinical information
- Provides personalized referrals to individuals or physicians/clinics requiring specialty services from a contracted medical group, hospital, or third-party payor.
- Facilitates referrals to appropriate Sutter facility, program or affiliated and aligned specialists.
Benefits
- Sutter Health values and supports the unique talents and strengths that each employee brings to our organization.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
