Transfer & Referral Specialist II

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 transfers 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 in Business and/or Healthcare Administration, or related field. TYPICAL EXPERIENCE: • 2 years of recent relevant experience. 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: 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: 32 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $28.00 to $52.56 / 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.