Role Description
This is a hands-on role for someone who thrives in high-volume operational environments and is comfortable balancing individual contribution with team support. You will continue to process prior authorizations directly—often at high volume—while also serving as a go-to resource for other Ascertain Assistants. Over time, this role will evolve into a hybrid operations + technology position as workflows become increasingly automated and integrated with Ascertain’s platform. This is not a traditional healthcare shift-based, desk role. It is an outcome-driven position that rewards ownership, judgment, and follow-through.
What You’ll Do:
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Play a critical role in our new AI-powered prior authorization solution.
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Collaborate directly with Ascertain leadership and product teams.
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Work closely with healthcare providers to reduce administrative burdens and streamline detailed workflows.
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Manually process authorizations and oversee automated submissions for office visit referrals, procedures, pharmaceuticals, and more.
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Review and verify insurance information and patient eligibility for prior authorizations.
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Communicate with healthcare providers to gather necessary medical documentation and information.
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Submit prior authorization requests to insurance companies following established protocols.
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Monitor and track authorization requests to ensure timely processing and resolution.
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Respond to inquiries from healthcare providers, patients, and insurance companies regarding authorization status.
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Maintain accurate records of authorization requests, approvals, and denials.
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Collaborate with internal teams to resolve authorization issues and improve process efficiency.
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Stay updated on insurance policies, regulations, and industry trends related to prior authorizations.
Qualifications
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4+ years of experience with prior authorization and billing in Oncology.
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Experience with athenahealth and/or NextGen.
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Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield, etc.
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Bonus if you have experience in client relationships.
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Hands-on leadership roles (e.g., Team Lead, Supervisor, or informal leadership), paired with a roll-up-your-sleeves approach.
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Engaging with C-suite executives.
What You'll Bring to the Table:
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Detail-Oriented: Meticulous in your work, catching errors and ensuring every authorization is processed accurately the first time.
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Collaborative: Energized by working with others, building trust and communicating clearly with providers, teammates, and cross-functional stakeholders.
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Adaptable: Comfortable shifting between manual workflows and leveraging new AI-powered tools, adjusting quickly as processes evolve.
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Empathetic: Attuned to the needs of healthcare providers and patients, approaching each interaction with patience, professionalism, and understanding.
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Process-Driven: Motivated by structure and consistency, following established workflows while identifying opportunities for improvement.
Benefits
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Cutting-edge technology: Work directly with the latest advancements in generative AI and automation, tackling challenging problems that meaningfully impact healthcare.
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Ownership & growth: Join Ascertain at a pivotal early stage, shaping our products, technical direction, and culture, with significant opportunities for career advancement.
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Collaborative team: Join a talented, passionate, and supportive team with backgrounds from top tech companies and clinical institutions.
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Competitive compensation: We offer competitive salary, meaningful equity, comprehensive health insurance, and more.
Why Ascertain?
Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI!