Prior Authorization Specialist - Health Systems/Post-Acute

Ascertain

13d • Hybrid

About The Position

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 team members. 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.
We are specifically looking for candidates with deep experience in post-acute and/or hospital-based prior authorization workflows, along with hands-on Epic experience. Exposure to outpatient specialty care is a strong plus.

Requirements

• 4+ years of prior authorization experience, including hospital-based and/or post-acute care settings (required)
• Hands-on experience working in Epic (required)
• Familiarity with major payors (UnitedHealthcare, Aetna, BCBS, etc.)
• Strong understanding of complex care transitions and authorization nuances across care settings

Nice To Haves

• Experience across multiple specialties (e.g., oncology, cardiology, rehab, pharmacy, etc.) is a plus

Responsibilities

• Review and verify insurance information and patient eligibility for prior authorizations
• Communicate with hospital teams, post-acute providers, and outpatient specialists to gather required documentation
• Submit prior authorization requests to payors using established workflows and Epic-based processes
• Monitor and track authorization requests to ensure timely processing and follow-up
• Respond to inquiries from providers, patients, and payors regarding authorization status
• Maintain accurate and detailed records of submissions, approvals, and denials
• Troubleshoot complex cases, especially those involving transitions of care (e.g., inpatient → post-acute)
• Collaborate with internal teams to improve workflows and support automation efforts
• Stay current on payor policies, Epic workflows, and industry changes

Benefits

• 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.
• Flexible hybrid work: We support a flexible hybrid working model from our NYC office, trusting you to manage your own schedule.
• Competitive compensation: We offer competitive salary, meaningful equity, comprehensive health insurance, and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed