Transfer & Referral Specialist

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.

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:

Days

Schedule:

Part Time

Shift Hours:

8

Days of the Week:

Variable

Weekend Requirements:

Every other Weekend

Benefits:

Yes

Unions:

No

Position Status:

Non-Exempt

Weekly Hours:

24

Employee Status:

Regular

Number of Openings:

1

This position may regularly work, store, prepare, receive, unpack, transport, dispose of, or administer drug(s) identified as hazardous, or potentially hazardous, by the National Institute for Occupational Safety and Health (NIOSH) for purposes of USP 800.

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

Pay Range is $32.28 to $48.42 / hour

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.