Prior Authorization Assistant - Imaging/Radiology

Ascertain

6d•$45,000 - $65,000

About The Position

Ascertain is building AI agents to automate administrative work for care teams. The Prior Authorization Assistant will support Ascertain’s AI-powered prior authorization solution, working directly with radiology practices and imaging centers to reduce administrative burden and streamline complex workflows. The role combines high-volume, hands-on authorization processing with support for other Ascertain Assistants and collaboration with company leadership and product teams. Over time, it is expected to evolve into a hybrid operations and technology position as workflows become more automated and integrated with Ascertain’s platform. The position involves processing authorizations and overseeing automated submissions for advanced imaging—including MRI, CT, PET, and nuclear medicine—as well as diagnostic and interventional radiology procedures and related referrals. It is outcome-driven rather than a traditional shift-based desk role, and offers exposure to multiple specialties, external stakeholders, and Ascertain departments.

Requirements

At least 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, paired with a willingness to perform direct operational work.
Detail-oriented, collaborative, adaptable, empathetic, and process-driven approach.

Responsibilities

Review and verify insurance information and patient eligibility for imaging and radiology prior authorizations.
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 to ensure 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 when 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 requirements, regulations, and industry trends affecting imaging authorizations.
Process prior authorizations directly at high volume while serving as a go-to resource for other Ascertain Assistants.
Oversee automated submissions and collaborate with Ascertain leadership and product teams on the prior authorization solution.