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Referral Support Team Intake Specialist - Hybrid Remote

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Requisition # HRC1280164

Grow your career at Cedars-Sinai!

Cedars-Sinai Medical Center has been ranked the #1 hospital in California and #2 hospital in the nation by U.S. News & World Report, 2022‑23. When you join our team, you’ll gain access to our state-of-the-art biomedical research facilities and advanced medical education programs. We are dedicated to helping you further your expertise — we offer learning programs, tuition reimbursement and performance-improvement projects so you can achieve additional certifications and degrees while gaining the knowledge and experience needed to advance your career.

We take pride in hiring the best, most passionate employees. Our talented doctors, nurses and staff reflect the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for.

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:

  • 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.
  • Connect with current clients to ensure customer happiness via ‘outbound calls’ that support outreach efforts while providing concierge care.
  • Maintain accurate and complete records for each referral by entering information into CS-Link.
  • Be responsible for financial clearance of referrals from non-contracted entities, from specific product lines, prior to triaging to tertiary program
  • Monitor existing referrals to ensure patients are scheduled timely

 


Experience Requirements:

Three (3)+ years' experience in utilization management/authorizations for IP/OP referrals in either a hospital system, health plan, and or medical group setting.

Proven understanding in California health insurance market including a proven understanding of HMO product lines.

Knowledge of CPT and ICD-10 codes. (preferred)

Understanding of medical terminology. (preferred)

Education/Licenses/Certification Requirements:

High School Diploma or GED.

Associate’s and/or Bachelor’s degree preferred.

Licensed Vocational Nurse (LVN) preferred.

Jobs

LI-Hybrid


Working Title: Referral Support Team Intake Specialist - Hybrid Remote
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:$26.83 - $41.59

Our compensation philosophy

We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above takes into account the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. Pay Transparency Non Discrimination Provision

Diversity and Inclusion at Cedars-Sinai

We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve – because that’s what our patients, colleagues and communities deserve. Quality Care and Research—For All, By All.

Cedars-Sinai is an Equal Employment Opportunity employer.

Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.

Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.

At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu) and COVID-19. For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines such as COVID-19 as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy. Cedars-Sinai’s AA Policy Statement

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