[Hiring] Transfer & Referral Specialist II @Sutter Health

Role Description

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.

Qualifications

• 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.

Requirements

• 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.

Benefits

• 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.