Transfer & Referral Specialist - Sutter Health : Job Details

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).

Job Description:

Education:

• Bachelor's: Business and/or Healthcare Administration, or related field. or equivalent education/experience

Preferred Experience as Typically Acquired in:

• 5 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.
• 5 years' experience in an acute and/or non-acute healthcare setting.
• 5 years' experience working with computerized systems and/or electronic medical record.

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 HIPAA 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: Variable

Weekend Requirements: Every other Weekend

Benefits: Yes

Unions: No

Position Status: Non-Exempt

Weekly Hours: 32

Employee Status: Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $33.26 to $49.89 / hour