AI‑Powered Prior Authorization Specialist

Ascertain; United States; Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Cutting-edge AI tech

Equity opportunity

Health insurance

Job summary

Ascertain is hiring a Prior Authorization Assistant to support our AI-powered authorization workflow across multiple healthcare specialties. You will manually process high-volume authorizations while guiding automated submissions and collaborating with leadership and product teams to improve the process.

This role blends hands-on operational work with emerging AI-driven tools, offering exposure to providers, payors, and cross-functional teams as workflows evolve within Ascertain’s platform.

Qualifications

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

Responsibilities

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

Skills

Detail-oriented

Collaborative

Adaptable

Empathetic

Process-driven

Tools

athenahealth

NextGen

Job description

Ascertain is hiring a Prior Authorization Assistant to support our AI-powered authorization workflow across multiple healthcare specialties. You will manually process high-volume authorizations while guiding automated submissions and collaborating with leadership and product teams to improve the process.

This role blends hands-on operational work with emerging AI-driven tools, offering exposure to providers, payors, and cross-functional teams as workflows evolve within Ascertain’s platform.