[Hiring] Transfer & Referral Specialist Lead @Sutter Health

Role Description

Responsible for assisting with assigning work to staff and day-to-day operations. Provides functional guidance and direction to the staff. Maintains statistics for the department and ensures established turnaround times are adhered to. Reviews daily work volumes of the referral pools and distributes work accordingly. Reviews, modifies, and researches, as directed to make recommendations to update policies and procedures to improve referral and authorization processing.

Qualifications

• Bachelor's: Business and/or Healthcare Administration, or related field.
• Equivalent experience will be accepted in lieu of the required degree or diploma.
• 4 years 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

• Comprehensive benefits package.

Company Description

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

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.