Referral/Transfer Specialist – Referral Navigation
| Company | Sutter Health |
|---|---|
| Location | Sacramento, CA, USA, Utah, USA |
| Salary | $33.26 – $49.89 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Junior, Mid Level |
Requirements
- Bachelor’s in Business and/or Healthcare Administration, or related field (equivalent experience will be accepted in lieu of the required degree or diploma)
- 2 years of recent relevant experience
- 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.
Responsibilities
- 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.
Preferred Qualifications
-
No preferred qualifications provided.