Prior Authorization Assistant

This is a fully remote position, open to applicants in United States.

📋 Description

• Directly handle prior authorizations, often managing a high volume.

• Act as a key resource for other Ascertain Assistants.

• Partner with Ascertain leadership and product teams to design AI-enhanced prior authorization workflows.

• Collaborate closely with healthcare providers to alleviate administrative burdens and optimize workflows.

• Manually process and oversee automated submissions for office visit referrals, procedures, pharmaceuticals, and more.

• Review and authenticate insurance information and patient eligibility.

• Collect medical documentation and data from healthcare providers.

• Submit prior authorization requests to insurance companies in accordance with established protocols.

• Monitor and track authorization requests to ensure timely processing and resolution.

• Address authorization-status inquiries from providers, patients, and insurance companies.

• Maintain precise records of authorization requests, approvals, and denials.

• Work with internal teams to address authorization challenges and enhance process efficiency.

• Stay informed about insurance policies, regulations, and trends in the prior authorization industry.

⛳️ Requirements

• Minimum of 4 years of experience in prior authorization.

• Background in various specialties, including Oncology/Hematology, Cardiology, Physical Therapy, and Pharmacy.

• Familiarity with athenahealth and/or NextGen systems.

• Knowledge of major payors, such as UnitedHealthcare, Aetna, and Blue Cross Blue Shield.

• Bonus: experience managing client relationships.

• Bonus: involvement in leadership roles like Team Lead, Supervisor, or informal leadership positions.

• Bonus: experience engaging with C-suite executives.

• Detail-oriented with a strong focus on accuracy and meticulousness.

• Collaborative, with the ability to communicate effectively with providers, teammates, and cross-functional stakeholders.

• Adaptable to both manual workflows and AI-driven tools.

• Empathetic and professional in interactions with healthcare providers and patients.

• Process-oriented, capable of adhering to established workflows while identifying areas for improvement.

🏝️ Benefits

• Access to cutting-edge technology: Engage directly with the latest advancements in generative AI and automation.

• Ownership and growth opportunities with significant potential for career advancement.

• Collaborative team comprised of individuals from leading tech companies and clinical institutions.

• Competitive compensation package.

• Meaningful equity participation.

• Comprehensive health insurance coverage.