Referral Support Team Intake Specialist

Align yourself with an organization that has a reputation for excellence. Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company’s Workplace of the Year. We offer an outstanding benefits' package that includes health care, generous time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.

What will I be doing in this role?

The Intake Specialist will be responsible for handling and facilitating all specialty referrals generated by the Referral Support team. Responsible for understanding all specialty services and programs at Cedars-Sinai Medical Center and will process referrals from inception to completion. The individual will have knowledge regarding medical groups, HMOs, PPOs, health systems, and third-party payers within the California health care market. They will work in tandem with the clinical staff within the Referral Support Team to triage referrals from community providers, health plans, and medical groups to appropriate Cedars-Sinai tertiary programs. You will:

• Maintain accurate and complete records for each referral by entering information into CS-Link.
• Review all incoming records, authorizations, and documentation to ensure all required information has been received prior to referral distribution Assess data (under the direction of licensed staff) to determine the clinical need for higher level of care and present the case to the appropriate Cedars-Sinai physician for possibility of acceptance.
• Verify exiting contracts for coverage and when needed, notify referring entity, receiving CSMC/CSMF program, or managed care department of the need for a letter of agreement prior to referral distribution.
• Monitor existing referrals to ensure patients are scheduled timely.
• Connect with current clients to ensure customer happiness via ‘outbound calls’ that support outreach efforts while providing concierge care.
• Be responsible for financial clearance of referrals from non-contracted entities, from specific product lines, prior to triaging to tertiary program.

Requirements:

• Understanding of medical terminology preferred.
• Proven understanding in California health insurance market including a proven understanding of HMO product lines.
• Licensed Vocational Nurse (LVN) or California RN License preferred.
• High School Diploma or GED required. Associate or bachelor’s degree preferred.
• Three (3) + years' experience in utilization management/authorizations for IP/OP referrals in either a hospital system, health plan, and or medical group setting required.
• Knowledge of CPT and ICD-10 codes preferred

Why work here?

Beyond outstanding employee benefits, we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.

Working Title: Referral Support Team Intake Specialist
Department: Corporate Sales
Business Entity: Cedars-Sinai Medical Center
Job Category: Strategic Plan/Business Dev
Job Specialty: Sales
Position Type: Full-time
Shift Length: 8 hour shift
Shift Type: Day
Base Pay:$26.31 - $40.78