Transfer & Referral Specialist

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

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

PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN

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.

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:

Evenings 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:

40

Employee Status:

Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $39.39 to $59.09 / 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. Working at Sutter Health Sutter Health values and supports the unique talents and strengths that each employee brings to our organization. As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.