Clinical Liaison III

We are so glad you are interested in joining Sutter Health! Organization: SRMC-Sutter Roseville Med Center Position Overview: Handles the day-to-day review, coordination and management of referral/authorization requests for services requiring clinical background and understanding from a provider operational and payer requirement perspective. Serves as a functional liaison to Financial Clearance Representatives (pre-service), Patient Access Representatives (point of service), insurance companies, physicians and hospital Administration. Enhances the patient experience throughout all interactions demonstrating knowledge of Sutter's Health system and service offerings. Facilitates Medicare National Coverage Determination (NCD) and Local Coverage Determination (LCD) process on behalf of Sutter Health hospitals to ensure physician and hospital compliance with conditions of coverage prescribed within Medicare National Coverage Determination. Job Description: EDUCATION: Graduate of an accredited school of nursing. CERTIFICATION & LICENSURE: RN-Registered Nurse of California TYPICAL EXPERIENCE: 2 years recent relevant experience. SKILLS AND KNOWLEDGE: Insurance payer knowledge and background. Working knowledge of medical and insurance terminology as well as an understand of healthcare insurance. Ability to carry out defined procedures and policies under specific instruction. Assertive, organized, self-directed and able to prioritize work assignments, perform multiple tasks concurrently. Ability to utilize multiple modes of communication (e.g. phone, fax, patient portal, e-mail, physician portal, mail, etc.) in a professional, accurate, efficient and courteous manner. Computer proficiency skills. Data entry skills. Verbal and written communication and active listening skills. Interpersonal skills necessary in dealing with internal and external customers. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Sutter Health. Accuracy and attentiveness to detail. Must be able to set and organize own work priorities, and adapt to change. Ability to meet or exceed targeted customer service, productivity and quality standards. Requires the ability to work with and maintain confidential information. Job Shift: Days Schedule: Short Hour Shift Hours: 8 Days of the Week: Variable Weekend Requirements: Rotating Weekends Benefits: No Unions: No Position Status: Non-Exempt Weekly Hours: 16 Employee Status: Short Hour Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $63.49 to $79.36 / 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. Working at Sutter Health Sutter Health values and supports the unique talents and strengths that each employee brings to our organization. As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.