Prior Authorization Assistant, Oncology

About the Company

Ascertain is building AI agents to automate the administrative work that burdens care teams. We are in major health systems and large specialty groups, saving hundreds of staff hours every week. Our backers include Northwell Health and Deerfield Management.

Responsibilities

• Process prior authorizations directly at high volume
• Review and verify insurance information and patient eligibility
• 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 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 industry trends
• Collaborate with leadership and product teams to shape AI-powered prior authorization solutions

Requirements

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

Preferred Qualifications

• Experience in client relationships
• Hands-on leadership experience (Team Lead, Supervisor, or informal leadership)
• Experience engaging with C-suite executives