Transfer & Referral Specialist

Sutter HealthSacramento, CA
$34 - $51Hybrid

About The Position

We are so glad you are interested in joining Sutter Health! Organization: SMCS-Valley Administration 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. This position is hybrid (most days onsite and some days remote).

Requirements

  • Equivalent experience will be accepted in lieu of the required degree or diploma.
  • Bachelor's: Business and/or Healthcare Administration, or related field. or equivalent education/experience
  • 2 years progressively responsible experience in healthcare/medical insurance, Health Information Management, Admitting/Patient Access, Patient Financial Services, and/or Case Management as typically acquired in three or more years.
  • 2 years' experience in an acute and/or non-acute healthcare setting.
  • 2 years' experience working with computerized systems and/or electronic medical record.
  • 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.

Nice To Haves

  • PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:
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