Cedars-Sinai Referral Support Team Intake Specialist - Hybrid Remote in Los Angeles, California
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‑
- 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
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)
High School Diploma or GED.
Associate’s and/or Bachelor’s degree preferred.
Licensed Vocational Nurse (LVN) preferred.
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
Cedars-Sinai is an EEO 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.