Sutter Health Referral Management Specialist - Referrals (Full Time, Limited Term - Days) in Sacramento, California
The Referral Management Specialist is responsible for the processing of all requests for referrals, including HMO, PPO, RAFS and TARS. They are responsible for batching and logging all materials that arrive within the Medical Management Department. Representative will be responsible for daily logs and will provide Medical Management Staff with appropriate statistics. The Representative will have specific guidelines to follow for the approval of specific types of requests. The Representative will be responsible for confirming all eligibility on requests for referrals or authorizations. The Representative will be responsible for notifying patients of the status of the referral/authorization, and if necessary will facilitate any appointments necessary.
AA Degree in Business/Health-Related field or equivalent experience in health care required.
Related course work in business and computer skills preferred.
Experience within a health care setting is preferred. Previous experience in a technical support or administrative position preferred. Demonstrated ability to positively handle public contacts and effectively organize and maintain workflow systems with rapidly changing priorities. Proficient knowledge of multiple computer software products preferred.
Correct grammar, composition and English. Working knowledge of medical terminology, andcoding, (e.g., ICD-9, CPT-4, HCPCS ) preferred. Excellent communication skills, both verbaland written are required. Ability to work independently and effectively establish work prioritieswhile receiving work from more than one person. Ability to maintain the integrity of confidential information. Experience in a managed care environment preferred. Knowledge ofdata collection techniques and reporting of data preferred.
· Special Skills/Equipment
PC proficiency in Microsoft products preferred. Demonstrated ability to professionally handle public contact. Must have effective analytical and problem solving skillsto support Medical Management staff. Effectively interacts with individuals from all levels of theorganization. Ability to work independently with minimal direction in a fast-paced environment.
Organization: Sutter Medical Foundation - West
Employee Status: Limited Term
Employee Referral Bonus: No
Position Status: Non-Exempt
Job Shift: Day
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Monday-Friday
Weekend Requirements: Other
Schedule: Full Time
Hrs Per 2wk Pay Period: 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.