Job Description:
• Process prior authorizations directly, often at high volume
• Serve as a go-to resource for other Ascertain Assistants
• Collaborate with Ascertain leadership and product teams to shape AI-powered prior authorization workflows
• Work closely with healthcare providers to reduce administrative burdens and streamline workflows
• Manually process and oversee automated submissions for office visit referrals, procedures, pharmaceuticals, and more
• Review and verify insurance information and patient eligibility
• Gather medical documentation and information from healthcare providers
• Submit prior authorization requests to insurance companies following established protocols
• Monitor and track authorization requests for timely processing and resolution
• Respond to authorization-status inquiries from providers, patients, and insurance companies
• 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 prior-authorization industry trends
Requirements:
• 4+ years of experience with prior authorization
• Experience in multiple specialties, such as Oncology/Hematology, Cardiology, Physical Therapy, and Pharmacy
• Experience with athenahealth and/or NextGen
• Familiarity with major payors including UnitedHealthcare, Aetna, and Blue Cross Blue Shield
• Bonus: experience in client relationships
• Bonus: hands-on leadership roles such as Team Lead, Supervisor, or informal leadership
• Bonus: experience engaging with C-suite executives
• Detail-oriented, meticulous, and accurate
• Collaborative and able to communicate clearly with providers, teammates, and cross-functional stakeholders
• Adaptable to manual workflows and AI-powered tools
• Empathetic and professional when interacting with healthcare providers and patients
• Process-driven and able to follow established workflows while identifying improvements
Benefits:
• Cutting-edge technology: Work directly with the latest advancements in generative AI and automation
• Ownership & growth with significant opportunities for career advancement
• Collaborative team with backgrounds from top tech companies and clinical institutions
• Competitive compensation
• Meaningful equity
• Comprehensive health insurance