Network Prior Authorization and Referral Specialist

This role ensures accurate financial clearance and proper reimbursement for St. Luke's Primary Care and Specialty practices by managing prior authorizations, insurance referrals, and peer-to-peer evaluations. The position involves verifying financial information, monitoring diagnostic appointments, and utilizing Epic Work Queues to streamline billing and documentation workflows. Key duties include contacting health plans for appeals and notifying providers of authorization requirements to maintain operational revenue.