AI-Powered Radiology Prior Authorization Specialist

Ascertain; United States; Remote; USD 65.000 - 90.000; Vollzeit

Zusammenfassung

Ascertain in the United States is seeking a hands-on Prior Authorization Assistant to support high-volume radiology workflows. You will process prior authorizations, coordinate with radiology teams and payors, and help shape AI-powered automation initiatives across Ascertain’s platform.

This role rewards ownership and practical problem-solving as workflows evolve toward integrated AI tools; you will collaborate with leadership and across departments to reduce administrative burden and improve

Qualifikationen

• 4+ years of experience with prior authorization and billing in radiology/diagnostic imaging.
• Experience with athenahealth and/or NextGen.
• Familiar with major payors and radiology benefit managers (RBMs) such as EviCore and Carelon.
• Experience with oncology prior authorization and billing, including PET/CT.
• Hands-on leadership experience with a roll-up-your-sleeves approach.

Aufgaben

• Review and verify insurance information and patient eligibility for imaging priors.
• Coordinate with ordering providers and imaging teams to gather documentation.
• Submit prior authorization requests per protocols and payor guidelines.
• Monitor requests to ensure timely processing and resolution.
• Respond to inquiries from providers, patients, and payors.
• Manage denials and peer-to-peer requests, supporting appeals.
• Maintain records of authorization requests, approvals, and denials.
• Collaborate with internal teams to resolve issues and improve efficiency.
• Stay current on payor policies and RBM requirements affecting imaging.

Kenntnisse

Prior authorization

Billing

Radiology/imaging

Athenahealth

NextGen

Leadership

Jobbeschreibung

Ascertain in the United States is seeking a hands-on Prior Authorization Assistant to support high-volume radiology workflows. You will process prior authorizations, coordinate with radiology teams and payors, and help shape AI-powered automation initiatives across Ascertain’s platform.

This role rewards ownership and practical problem-solving as workflows evolve toward integrated AI tools; you will collaborate with leadership and across departments to reduce administrative burden and improve