Cardiology Prior Authorization Specialist - AI-Powered Ops

Ascertain; United States; Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Cutting-edge technology

Ownership & growth

Collaborative team

Competitive compensation

Job summary

Ascertain is seeking a hands-on Prior Authorization Assistant to handle high-volume prior authorizations and serve as a resource for the Ascertain Assistants. The role will evolve into a hybrid operations + technology position as automated workflows are integrated with Ascertain’s platform.

You will work with healthcare providers to reduce administrative burdens and oversee automated submissions for referrals, procedures, pharmaceuticals, and more, gaining exposure to multiple specialties and

Qualifications

• 4+ years of experience with prior authorization and billing in Cardiology.
• 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 hands-on Prior Authorization Assistant to handle high-volume prior authorizations and serve as a resource for the Ascertain Assistants. The role will evolve into a hybrid operations + technology position as automated workflows are integrated with Ascertain’s platform.

You will work with healthcare providers to reduce administrative burdens and oversee automated submissions for referrals, procedures, pharmaceuticals, and more, gaining exposure to multiple specialties and