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 transfers to appropriate Sutter facility, program or affiliated and aligned specialists.
Job Description:
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:Nights
Schedule:Full Time
Shift Hours:8
Days of the Week:Variable
Weekend Requirements:Every other Weekend
Benefits:Yes
Unions:No
Position Status:Non-Exempt
Weekly Hours:32
Employee Status:Limited Term (Fixed Term)
Pay Range is $28.00 to $52.56 / hour
The posted pay range is based on the position's primary work location. Candidates who reside and work outside of that location may be subject to a different pay range based on their work location. Candidate starting salaries consider 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.
