Prior Authorization Assistant - Imaging/Radiology

MEET ASCERTAIN 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, New York’s largest health system, and Deerfield Management, a leading healthcare investment firm. Together, we’re on a mission to restore time, trust, and focus to the people who keep healthcare running. Our work is urgent — not because of startup timelines, but because our customers rely on us to drive financial resilience and operational clarity in a system under strain. ABOUT THE JOB This is a hands-on role for someone who thrives in high-volume operational environments and is comfortable balancing individual contribution with team support. You will continue to process prior authorizations directly, often at high volume, while also serving as a go-to resource for other Ascertain Assistants. Over time, this role will evolve into a hybrid operations + technology position as workflows become increasingly automated and integrated with Ascertain’s platform. This is not a traditional healthcare shift-based desk role. It is 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 our new AI-powered prior authorization solution. You’ll collaborate directly with Ascertain leadership and product teams, helping to shape how prior authorization is transformed through recent advances in artificial intelligence. This is a unique opportunity to work at the intersection of healthcare operations and cutting-edge technology. You’ll work closely with radiology practices and imaging centers to reduce administrative burden and streamline complex workflows. Day to day, this includes manually processing authorizations and overseeing automated submissions for advanced imaging (MRI, CT, PET, nuclear medicine), diagnostic and interventional radiology procedures, and related referrals. The 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. BENEFITS & PERKS • Cutting-edge technology: Work directly with the latest advancements in generative AI and automation, tackling challenging problems that meaningfully impact healthcare. • Ownership & growth: You’ll join Ascertain at a pivotal early stage, shaping our products, technical direction, and culture, with significant opportunities for career advancement. • Collaborative team: Join a talented, passionate, and supportive team with backgrounds from top tech companies and clinical institutions. • Competitive compensation: We offer competitive salary, meaningful equity, comprehensive health insurance, and more. Why Ascertain? Make a real difference: Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI! Compensation: $45K - $65K