Referral Management Specialist - Centralized Referral Center (Full Time - Days)
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
+ AA Degree inBusiness/Health-Related field or equivalent experience in health care required.
+ Related course work in business and computerskills preferred.
+ Experience within a health care setting is required.
+ Previous experience in atechnical support or administrative position required.
**S** **kills /** **Knowledge:**
+ Correctgrammar, composition and English.
+ Working knowledge of medical terminology, andcoding,(e.g., ICD-10, CPT-4, HCPCS ) preferred.
+ Excellentcommunication skills, both verbalandwritten are required.
+ Ability towork independently and effectively establish work prioritieswhile receivingwork from more than one person.
+ Ability to maintain the integrity ofconfidentialinformation.
+ Experience in a managed care environment preferred.
+ Knowledge ofdatacollection techniques and reporting ofdata preferred.
+ PCproficiency in Microsoft products preferred.
+ Demonstrated ability to professionally handle public contact.
+ Musthave effective analytical and problemsolving skillsto support MedicalManagement staff.
+ Effectively interactswith individuals from all levels of theorganization.
+ Ability to work independentlywith minimal direction in a fast-paced environment.
**Organization:** Sutter Medical Foundation - Central
**Employee Status:** Regular
**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:** None
**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.
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.
Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you – and excellent, personalized care for all those we serve.