California Transfer Referral Specialist

Job Summary

To support clinical integration efforts, the full-time California Transfer Referral Specialist will review confidential clinical information, facilitate referrals to appropriate specialists, and manage documentation and communication processes in a remote environment.

Key responsibilities

• Receive and process referral requests, collecting necessary clinical and insurance information to identify appropriate services and specialists
• Document referral interactions and actions in the database, including follow-up tracking and performing peer-to-peer audits
• Ensure timely communication with physicians and case management, maintaining an updated list of available clinical procedures and capabilities

Required qualifications

• Bachelor's degree in Business, Healthcare Administration, or a related field, or equivalent experience
• Minimum of 2 years of recent relevant experience in a healthcare setting
• Working knowledge of managed care requirements and insurance authorization processes
• Familiarity with medical terminology and third-party payers
• Ability to maintain confidentiality and manage sensitive information effectively