Authorization and Referral Specialist

## Overview The Authorization and Referral Specialist is responsible for friendly, courteous, professional, and informative customer service to the company’s patients seeking to schedule appointments or needing other information or service. The Authorization and Referral provide a caring and compassionate impression on all clients of the company. \*\*MCR Health is a drug-free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check. ## Description **Authorization and Referral Specialist** Job Title: Authorization and Referral Specialist Department: Authorization and Referral Division: MCR FLSA Class: Non-exempt Pay Grade: Reports To: Director of Revenue Cycle Supervises: N/A **Position Summary** The Authorization and Referral Specialist is responsible for friendly, courteous, professional, and informative customer service to the company’s patients seeking to schedule appointments or needing other information or service. The Authorization and Referral provides a caring and compassionate impression on all clients of the company. **Essential Duties and Responsibilities** - Provides friendly, courteous, and professional service at all time to all clients and patients - Has an excellent understanding of telephone usage and the operation of the telephone system - Answers in-coming telephone calls within three (3) rings and accurately directs and/or assists the caller - Forwards calls accurately to the correct person or extension and ensures that someone is answering on the extension before passing the caller - Demonstrates competency and proficiency with the electronic medical patient information system - Calls patients to schedule advanced and same day appointments and accurately enters new or follow-up information into the electronic medical patient information system - Maintains and updates any patient or telephone logs that may be requested - Explains services and operating hours; knowledgeable about services offered - Completes and verifies patient eligibility and authorizations - Ensures that the referral authorization process is completed timely and accurately - Informs and guides patients to appropriate resources - Documents if an authorization is denied form the PCP, or the insurance company including the reason and date of services - Schedules patient appointments for the referred service with the indicated specialist’s office, providing them with authorization information, including authorization number - Contacts the patient informing them of the appointment information including date, time, location, and any other instructions required for the referred visit - Maintains referral/authorization information for tracking - Screens OB patients for presumptive eligibility for Pregnant Women (PEPW) and simplified Medicaid application - Understands the documentation required to substantiate the financial category of the patient and is able to articulate the requirements to the patient to obtain the necessary information - Obtains, verifies, and/or updates demographics and insurance information in the appropriate electronic patient health information systems - Maintains open communication with the Front Desk, Nursing Department, Providers, and insurance companies - Updates patient information into the electronic medical patient information system as needed - Supports the goals and mission of MCR Health Services. - Adheres to the safety policies of MCR Health Services. - Performs other duties as assigned. **Skills** - Outstanding communication and customer service skills - Active Listening - Excellent written and oral expression - Problem Solving - Ability to multi-task - Empathy - Ability to maintain confidences - Ethical **Requirements** - High School Graduate or GED equivalent. - Minimum of six months of customer service experience in a high-volume impact environment, preferably in a healthcare field. - Excellent customer service expertise. - Knowledge of…