Sutter Health Referral Management Specialist - Centralized Referral Center (Full Time - Days) in Sacramento, California

Position Overview:

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 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

Benefits: Yes

Position Status: Non-Exempt

Union: No

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.