Transfer & Referral Specialist II

Sutter Health•Sacramento, CA

10d•$28 - $53

About The Position

The Transfer & Referral Specialist II reviews confidential clinical information and provides personalized referrals to individuals or physicians and clinics seeking specialty services from a contracted medical group, hospital, or third-party payor. The role facilitates transfers to an appropriate Sutter facility, program, or affiliated and aligned specialist. This is a limited-term, fixed-term, non-exempt position with a full-time schedule of 32 hours per week. The night shift is eight hours, with variable days and every-other-weekend requirements.

Requirements

A bachelor's degree in Business and/or Healthcare Administration or a related field; equivalent experience may be accepted in lieu of the degree.
Two years of recent relevant experience.
Working knowledge of managed care requirements and processes.
Knowledge of system, affiliate, and community resources, and third-party payers such as PPOs, HMOs, Medicare, and insurance plans.
Knowledge of insurance authorization processes and HIPAA requirements.
Familiarity with medical and managed-care terminology.
Understanding of disease processes to assess referral requests and determine the appropriate level or provider of care.
Ability to define issues, collect data, establish facts, and draw valid conclusions.
Customer-service focus in decisions and actions.
Ability to communicate verbally and in writing and present information to varied audiences.
Organizational skills to manage and reprioritize activities and projects to meet deadlines.
Ability to interact effectively and maintain working relationships with others.
Respect for cultural and linguistic differences and commitment to promoting an inclusive work environment.
Ability to work effectively in a dynamic, fast-paced environment with changing priorities.
Ability to use essential applications and databases associated with the role.

Responsibilities

Review confidential clinical information.
Provide personalized referrals to individuals or physicians and clinics requiring specialty services from a contracted medical group, hospital, or third-party payor.
Facilitate transfers to an appropriate Sutter facility, program, or affiliated and aligned specialist.
Manage and reprioritize activities and projects to meet deadlines while maintaining responsiveness.
Maintain effective working relationships with people contacted in performing required duties.
Provide feedback and input to improve workflows and processes.
Work discreetly with confidential and sensitive information.