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:
- 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.
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 required.
- 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.
- High School Diploma or GED required. Associate or bachelor’s degree preferred.
- California Licensed Vocational Nurse (LVN) or RN License preferred.
- American Heart Association (AHA) or American Red Cross (ARC) BLS certification for LVN or RN required.
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
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 (PDF) (opens in new window)
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 (opens in new window).
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 (PDF) (opens in new window)
