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Transfer & Referral Specialist II

Sutter Health

Sacramento, CARemoteFull-time$28–52.56/hrPosted 1w agoChecked 1w ago

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At a glance

Compensation
$28–52.56/hr
Location
Sacramento, CARemote
Schedule
Full-time
Work Authorization
Not specified

Requirements

Credentials this posting asks for.

Bachelor's degree

Job overview

Sutter Health is hiring a Transfer & Referral Specialist II. Transfer & Referral Specialist II reviews confidential clinical information and provides personalized referrals to individuals or physicians/clinics needing specialty services. The role facilitates referrals to appropriate Sutter facilities, programs, or affiliated specialists, ensuring compliance with managed‑care processes and third‑party payer requirements while maintaining confidentiality and delivering customer‑focused service.

Key focus areas include Reviews confidential clinical information and provides personalized referrals to individuals or physicians/clinics requiring specialty services. and Facilitates referrals to appropriate Sutter facilities, programs, or affiliated and aligned specialists..

Important skills include Managed Care Requirements, Managed Care Processes, System Affiliate And Community Resources, Third-Party Payers, PPO, and HMO.

Skills & qualifications

RequiredNice to have

Skills

Managed Care RequirementsManaged Care ProcessesSystem Affiliate and Community ResourcesThird-Party PayersPPOHMOMedicareInsurance PlansInsurance Authorization ProcessHIPAA RequirementsMedical TerminologyManaged Care TerminologyDisease Process UnderstandingIssue DefinitionData CollectionFact EstablishmentConclusion DrawingCustomer Service FocusCommunicationPresentation SkillsOrganization SkillsReprioritizationWorking RelationshipsCultural CompetenceInitiativeFast-Paced Environment AdaptabilityConfidential Information HandlingEssential Applications Use

Qualifications

Bachelor's in Business and/or Healthcare Administration or Related FieldEquivalent Experience Accepted2 Years of Recent Relevant Experience

Full job description

We are so glad you are interested in joining Sutter Health!

Organization:

SHSO-Sutter Health System Office-Valley

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 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.

PHYSICAL ACTIVITIES AND REQUIREMENTS:

See required physical demands, mental components, visual activities & working conditions at the following link: Job Requirements

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Monday - Friday

Weekend Requirements:

Occasionally

Benefits:

Yes

Unions:

No

Position Status:

Non-Exempt

Weekly Hours:

40

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.

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