Prior Authorization Assistant at Ascertain

Ascertain is building AI agents to automate administrative work for care teams, saving hundreds of staff hours weekly. Backed by Northwell Health and Deerfield Management, Ascertain aims to restore time, trust, and focus to healthcare professionals by driving financial resilience and operational clarity.

This is a hands-on role for someone who excels in high-volume operational environments, balancing individual contributions with team support. You will process prior authorizations directly while also serving as a resource for other Ascertain Assistants. Over time, this role will evolve into a hybrid operations and technology position as workflows become increasingly automated and integrated with Ascertain’s platform.

This is not a traditional shift-based desk role but an outcome-driven position that rewards ownership, judgment, and follow-through.

What You’ll Do

As a Prior Authorization Assistant at Ascertain, you will play a critical role in their AI-powered prior authorization solution. You’ll collaborate with leadership and product teams to transform prior authorization through artificial intelligence.

You’ll work closely with radiology practices and imaging centers to reduce administrative burden and streamline workflows for advanced imaging (MRI, CT, PET, nuclear medicine), diagnostic and interventional radiology procedures, and related referrals. This role offers broad exposure to multiple specialties, external stakeholders, and departments across Ascertain.

• Review and verify insurance information and patient eligibility for imaging and radiology prior authorizations
• Work with ordering providers and imaging teams to gather clinical documentation, including indications, prior imaging, and supporting records
• Submit prior authorization requests to payors following established protocols and payor-specific imaging guidelines
• Monitor and track requests to ensure timely processing and resolution, including scheduling-sensitive and urgent studies
• Respond to inquiries from providers, patients, and payors about authorization status
• Manage denials and peer-to-peer requests, and support appeals where needed
• Maintain accurate records of authorization requests, approvals, and denials
• Collaborate with internal teams to resolve authorization issues and improve process efficiency
• Stay current on payor policies, radiology benefit manager (RBM) requirements, regulations, and industry trends affecting imaging authorizations

What You’ll Need

• 4+ years of experience with prior authorization and billing in radiology and/or diagnostic imaging
• Experience with athenahealth and/or NextGen
• Familiarity with major payors, including UnitedHealthcare, Aetna, and Blue Cross Blue Shield, and with radiology benefit managers such as EviCore and Carelon (formerly AIM)
• Experience with prior authorization and billing in oncology, including oncologic imaging and PET/CT
• Hands-on leadership experience (e.g., Team Lead, Supervisor, or informal leadership), paired with a roll-up-your-sleeves approach

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 new AI-powered tools, adjusting quickly as processes evolve.
• Empathetic. You are attuned to the needs of providers and patients, approaching each interaction with patience, professionalism, and understanding.
• Process-driven. You are motivated by structure and consistency, following established workflows while identifying opportunities for improvement.

Why Ascertain? Make a real difference: Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI!