AI-Powered Prior Authorization Specialist

Ascertain; New York (NY); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Cutting-edge technology

Ownership & growth

Collaborative team

Competitive compensation

Job summary

Ascertain is seeking a Prior Authorization Assistant to manage high-volume authorizations and become a go-to resource for Ascertain Assistants. The role evolves toward a hybrid operations + technology position as workflows integrate with Ascertain’s AI-powered platform.

You will work with healthcare providers to reduce administrative burdens, manually processing authorizations and overseeing automated submissions across various services, with exposure to multiple specialties and stakeholders.

Qualifications

• 4+ years of experience with prior authorization.
• Experience in multiple specialties (e.g., Oncology/Hematology, Cardiology, Physical Therapy, Pharmacy).
• Experience with athenahealth and/or NextGen.
• Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield, etc.

Responsibilities

• Review and verify insurance information and patient eligibility for prior authorizations.
• Communicate with healthcare providers to gather necessary medical documentation and information.
• Submit prior authorization requests to insurance companies following established protocols.
• Monitor and track authorization requests to ensure timely processing and resolution.
• Respond to inquiries from healthcare providers, patients, and insurance companies regarding authorization status.
• Maintain accurate records of authorization requests, approvals and denials.
• Collaborate with internal teams to resolve authorization issues and improve process efficiency.
• Stay updated on insurance policies, regulations, and industry trends related to prior authorizations.

Skills

Detail-oriented

Collaborative

Adaptable

Empathetic

Process-driven

Tools

athenahealth

NextGen

Job description

Ascertain is seeking a Prior Authorization Assistant to manage high-volume authorizations and become a go-to resource for Ascertain Assistants. The role evolves toward a hybrid operations + technology position as workflows integrate with Ascertain’s AI-powered platform.

You will work with healthcare providers to reduce administrative burdens, manually processing authorizations and overseeing automated submissions across various services, with exposure to multiple specialties and stakeholders.