Prior Authorization Assistant, Oncology

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

📋 Description

• Directly process prior authorizations, often handling a high volume of requests.

• Act as a primary resource for fellow Ascertain Assistants.

• Partner with Ascertain leadership and product teams to develop the AI-driven prior authorization solution.

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

• Manually handle authorizations while supervising automated submissions for office visit referrals, procedures, pharmaceuticals, and more.

• Review and confirm insurance details and patient eligibility.

• Collect medical documentation and information 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 inquiries from providers, patients, and insurance companies regarding authorization status.

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

• Work with internal teams to troubleshoot authorization issues and enhance process efficiency.

• Stay informed about insurance policies, regulations, and industry trends pertinent to prior authorizations.

• Assist in shaping workflows as the role transitions into a hybrid operations and technology position.

⛳️ Requirements

• Over 4 years of experience in prior authorization and billing within Oncology.

• Proficiency with athenahealth and/or NextGen.

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

• Experience in managing client relationships is a plus.

• Background in hands-on leadership roles, such as Team Lead, Supervisor, or informal leadership, is advantageous.

• Experience interacting with C-suite executives is a bonus.

• Detail-oriented, meticulous, and accurate in work.

• Strong collaborative communication skills with providers, teammates, and cross-functional stakeholders.

• Ability to adapt to both manual workflows and AI-powered tools.

• Professional and empathetic interactions with healthcare providers and patients.

• Process-driven mindset focused on established workflows and process improvement.

🏝️ Benefits

• Equity offerings.

• Comprehensive health insurance coverage.

• Competitive salary.

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

• Opportunities for ownership and significant career advancement.

• A collaborative team environment with skilled, passionate, and supportive colleagues.