Sutter Health

Transfer & Referral Specialist II

Sutter Health$71K — $106K *
Hospitals & Medical Centers
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Business, Healthcare Administration, or a related field; equivalent experience accepted
  • 2 years of relevant experience in healthcare or managed care settings
  • Working knowledge of managed care processes and insurance authorization
  • Familiarity with medical terminology and disease processes
  • Strong organizational and customer service skills
  • Ability to communicate effectively with diverse audiences
  • Capacity to manage confidential information discreetly

Responsibilities

  • Review confidential clinical information to identify appropriate specialty services
  • Provide personalized referrals to patients, physicians, and clinics
  • Facilitate referrals to Sutter facilities and aligned specialists
  • Assess referral requests to determine correct level of care
  • Enhance workflows by suggesting improvements in processes
  • Maintain effective working relationships with various stakeholders
  • Manage multiple tasks efficiently in a fast-paced environment

Benefits

  • Full-time schedule with Monday to Friday hours
  • Occasional weekend work required
  • Comprehensive benefits package available for eligible positions
  • Supportive work environment that values diversity and inclusion
Full Job Description
Organization:
SHSO-Sutter Health System Office-Valley

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.

Job Description:

T

EDUCATION:
Equivalent experience will be accepted in lieu of the required degree or diploma.

Bachelor's in Business and/or Healthcare Administration, or related field.

TYPICAL EXPERIENCE:

2 years of recent relevant experience.

SKILLS AND KNOWLEDGE:

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.

Job Shift:
Days

Schedule:
Full Time

Shift Hours:
8

Days of the Week:
Monday - Friday

Weekend Requirements:
Occasionally

Benefits:
No

Unions:
No

Position Status:
Non-Exempt

Weekly Hours:
40

Employee Status:
Regular

Pay Range is $34.25 to $51.38 / hour

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

About Sutter Health

Sutter Health is a not-for-profit health system in Northern California, headquartered in Sacramento. It includes doctors, hospitals and other health care services in more than 100 Northern California cities and towns. Major service lines of Sutter Health-affiliated hospitals include cardiac care, women’s and children’s services, cancer care, orthopedics and advanced patient safety technology.
Learn more about Sutter Health
Size
58,000 employees
Industry
Founded
1981

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