Referral Specialist Full-Time

Join Sutter Health
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. 5 years of recent relevant experience preferred.
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
Employees of Sutter Health and its entities may handle hazardous drugs in the course of their work, including patient care, which requires them to manage, store, prepare, receive, unpack, transport, dispose of, or administer drugs identified as hazardous or potentially hazardous by the National Institute for Occupational Safety and Health (NIOSH) and in accordance with the USP 800 guidelines.
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.
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