Transfer & Referral Specialist

Sutter Health•Sacramento, CA

13d•Onsite

About The Position

Reviews confidential clinical information and provides personalized referrals to individuals or physicians and clinics requiring specialty services from a contracted medical group, hospital, or third-party payor. Facilitates referrals to the appropriate Sutter facility, program, or affiliated and aligned specialists. This position is fully onsite.

Requirements

A bachelor's degree in business, healthcare administration, or a related field; equivalent education or experience is accepted in lieu of the degree.
Working knowledge of managed care requirements and processes.
Knowledge of system, affiliate, and community resources and third-party payers, including 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.
Effective verbal and written communication skills, including the ability to present information to varied audiences.
Organizational skills to manage and reprioritize activities and projects to meet deadlines.
Ability to maintain effective working relationships with people contacted in performing required duties.
Respect for cultural and linguistic differences and support for an inclusive work environment.
Ability to work effectively in a dynamic, fast-paced environment with changing business priorities.
Ability to use essential applications and databases associated with the role.
Ability to communicate and work effectively with others.

Nice To Haves

Two years of progressively responsible experience in healthcare or medical insurance, Health Information Management, Admitting/Patient Access, Patient Financial Services, and/or Case Management.
Two years of experience in an acute and/or non-acute healthcare setting.
Two years of experience working with computerized systems and/or electronic medical records.

Responsibilities

Review confidential clinical information.
Provide personalized referrals to individuals or physicians and clinics requiring specialty services.
Facilitate referrals to appropriate Sutter facilities, programs, or affiliated and aligned specialists.
Manage and reprioritize activities and projects to meet deadlines while maintaining responsiveness.
Work discreetly with confidential and sensitive information.
Provide feedback or input to improve workflows and processes.