Offer summary

Qualifications:

High School Diploma or GED required., Knowledge of medical terminology and coding (CPT, HCPCS, ICD-9) preferred., Proficiency in MS Office Excel and Word, and other Managed Care programs., Strong communication and organizational skills with problem-solving abilities..

Key responsibilities:

Process referral requests for patients to ensure timely and accurate determinations.

Assist providers and patients with inquiries regarding referral status.

Participate in the development and implementation of improvements to referral processes and workflows.

Maintain required turnaround times for referral completion.

Job description

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

Organization:

SHSO-Sutter Health System Office-Bay

Position Overview:

Processes referral requests for patients to achieve timely and accurate determinations. Works within scope of practice to complete or forward requests as appropriate to Managed Care physicians and/or nurses as per the Utilization Management (UM) protocols. Maintains required turnaround times for referral completion. Assists providers and patients with referral status questions. Participates in development and implementation of improvements to the referral process and workflows.

Job Description:

EDUCATION:

HS Diploma or GED
Medical terminology knowledge preferred.

SKILLS AND KNOWLEDGE:

Medical terminology, Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge.

Competency in using MS Office Excel and Word, other Managed Care programs.

Ability to identify, understand and solve problems related to claims and referrals.

Communication skills, including understanding of medical concepts, ability to organize thoughts, and communicate issues concisely and effectively.

Proven ability to quickly adjust to changing projects and priorities and to multi-task.

Organizational skills.

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

Days of the Week:

Monday - Friday

Weekend Requirements:

None

Benefits:

Yes

Unions:

Position Status:

Non-Exempt

Weekly Hours:

Employee Status:

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $29.60 to $37.00 / hour. California - Valley Range Pay Range is $25.74 to $32.17 / hour.

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.

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