Ascertain Prior Authorization Assistant at Ascertain processes high-volume prior authorizations and supports team members. The role involves collaborating with healthcare providers and internal teams to streamline workflows and improve efficiency.
Responsibilities
This is not a traditional healthcare shift-based, desk role. It is an outcome-driven position that rewards ownership, judgment, and follow-through.
As a Prior Authorization Assistant at Ascertain, you will play a critical role in our new AI-powered prior authorization solution. You’ll collaborate directly with Ascertain leadership and product teams, helping to shape how prior authorization is transformed through recent advances in artificial intelligence. This is a unique opportunity to work at the intersection of healthcare operations and cutting-edge technology.
You’ll work closely with healthcare providers to reduce administrative burdens and streamline detailed workflows. Day-to-day, this includes manually processing authorizations and overseeing automated submissions for office visit referrals, procedures, pharmaceuticals, and more. The role offers broad exposure to multiple healthcare specialties, external stakeholders, and departments across Ascertain.
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.
Qualification
Experience in multiple specialtiesBonus if you have experience inclient relationshipshands-on leadership roles (eengaging with C-suite executivesWhat You'll Bring to the TableDetail-OrientedCollaborativeAdaptable
Required
4+ years of experience with prior authorization
Experience in multiple specialties, (e.g., Oncology/Hematology, Cardiology, Physical Therapy, Pharmacy).
Experience with athenahealth and or NextGen
Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield, etc.
Bonus if you have experience in...
client relationships;
hands-on leadership roles (e.g., Team Lead, Supervisor, or informal leadership), paired with a roll-up-your-sleeves approach;
engaging with C-suite executives.
What You'll Bring to the Table:
Detail-Oriented. You are meticulous in your work, catching errors and ensuring every authorization is processed accurately the first time.
Collaborative. You are energized by working with others, building trust and communicating clearly with providers, teammates, and cross-functional stakeholders.
Adaptable. You are comfortable shifting between manual workflows and leveraging new AI-powered tools, adjusting quickly as processes evolve.
