Prior Authorization Assistant – Imaging/Radiology

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $45k - $65k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 4%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Ascertain

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2022

🏥 Healthcare

💼 Consulting

🤖 Artificial Intelligence

💰 $10M Series A - Ascertain on 2025-04

Healthcare • Consulting • Artificial Intelligence

Ascertain is an agentic AI-powered healthcare operations platform that automates administrative workflows such as prior authorizations, eligibility verification, referral processing, discharge planning, and denials management. Designed for provider groups, health systems, and payers, Ascertain ingests unstructured data, automates forms, integrates with legacy systems, and includes human-in-the-loop review and traceability to improve approval rates, reduce administrative burden, and accelerate patient access while demonstrating ROI in weeks.

📋 Description

• Process prior authorizations directly, often at high volume • Serve as a go-to resource for other Ascertain Assistants • Collaborate with Ascertain leadership and product teams to shape AI-powered prior authorization workflows • Work closely with radiology practices and imaging centers to reduce administrative burden and streamline workflows • Manually process authorizations and oversee automated submissions for MRI, CT, PET, nuclear medicine, diagnostic radiology, interventional radiology, and related referrals • Review and verify insurance information and patient eligibility • Gather clinical documentation from ordering providers and imaging teams, including indications, prior imaging, and supporting records • Submit prior authorization requests to payors according to established protocols and payor-specific imaging guidelines • Monitor and track requests for timely processing and resolution, including scheduling-sensitive and urgent studies • Respond to provider, patient, and payor inquiries about authorization status • Manage denials and peer-to-peer requests and support appeals • 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 requirements, regulations, and industry trends affecting imaging authorizations

🎯 Requirements

• 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 • Familiarity 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, such as Team Lead, Supervisor, or informal leadership • Roll-up-your-sleeves approach • Detail-oriented, meticulous work and authorization accuracy • Collaborative communication with providers, teammates, and cross-functional stakeholders • Adaptability between manual workflows and AI-powered tools • Empathy when interacting with providers and patients • Process-driven approach to established workflows and process improvement

🏖️ Benefits

• Equity • Opportunity to make a direct impact on healthcare organizations and patient care • Opportunity to work with AI-powered healthcare technology • Broad exposure to multiple specialties, external stakeholders, and departments across Ascertain

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