Oncology Prior Authorization Specialist — AI-Driven Ops

Ascertain; United States; Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Cutting-edge technology

Ownership & growth

Collaborative team

Competitive compensation

Job summary

Ascertain seeks a hands-on Prior Authorization Assistant to manage high-volume authorizations and support Ascertain Assistants. The role blends operations with evolving AI-enabled workflows, delivering accurate authorizations and collaborating with leadership and product teams.

You will work with healthcare providers to reduce administrative burdens, processing authorizations manually while overseeing automated submissions for referrals, procedures, and medications, across multiple specialties

Qualifications

• 4+ years of experience with prior authorization and billing in Oncology.
• Experience with athenahealth and/or NextGen.
• Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield.

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 insurance companies following established protocols.
• Monitor and track authorization requests to ensure timely processing and resolution.
• Respond to inquiries from healthcare providers, patients, and insurers regarding status.
• Maintain accurate records of authorization requests, approvals and denials.
• Collaborate with internal teams to resolve authorization issues and improve efficiency.
• Stay updated on policies, regulations, and trends related to prior authorizations.

Skills

Prior authorization & billing

athenahealth / NextGen

Payer knowledge (UnitedHealthcare, AET

Job description

Ascertain seeks a hands-on Prior Authorization Assistant to manage high-volume authorizations and support Ascertain Assistants. The role blends operations with evolving AI-enabled workflows, delivering accurate authorizations and collaborating with leadership and product teams.

You will work with healthcare providers to reduce administrative burdens, processing authorizations manually while overseeing automated submissions for referrals, procedures, and medications, across multiple specialties