Transfer & Referral Specialist II

Sutter Health • Sacramento, CA

9d

About The Position

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 transfers to an appropriate Sutter facility, program, or affiliated and aligned specialists.

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 PPO, HMO, 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 or reprioritize activities and projects to meet deadlines while maintaining responsiveness.
• Ability to interact and maintain effective working relationships with people contacted in the performance of duties.
• Respect for cultural and linguistic differences and commitment to promoting an inclusive work environment.
• Initiative in providing feedback and input to improve workflows and processes.
• Ability to work effectively in a dynamic, fast-paced environment with changing business priorities.
• Ability to handle confidential and sensitive information discreetly.
• Ability to use essential applications and databases associated with the role.

Responsibilities

• Review confidential clinical information.
• Provide personalized referrals to individuals or physicians/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 specialists.

Benefits

• Eligible positions include a comprehensive benefits package.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level