Transfer & Referral Specialist

Sutter Health•Sacramento, CA

4d•$34 - $51

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 referrals to appropriate Sutter facility, program or affiliated and aligned specialists. 5 years of recent relevant experience preferred.

Requirements

Equivalent experience will be accepted in lieu of the required degree or diploma.
Bachelor's in Business and/or Healthcare Administration, or related field.
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.