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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in prior authorization processes, particularly in Oncology, while effectively collaborating with healthcare providers and internal teams to enhance operational efficiency. Proficient in managing high-volume authorization requests and maintaining compliance with insurance protocols.
Highest-signal resume keywords
Prior Authorization ExperienceOncology Billing ExpertiseAthenahealth ProficiencyNextGen FamiliarityInsurance Policy Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Prior Authorization ProcessingInsurance VerificationMedical Documentation GatheringWorkflow StreamliningAutomated Submission Oversight
Soft Skills
Collaborative CommunicationDetail-OrientedEmpathetic InteractionsAdaptabilityProcess Improvement Mindset
Industry Keywords
Healthcare ProvidersC-Suite EngagementMajor PayorsAdministrative BurdensAuthorization Status Monitoring
About the role
Key responsibilities & impact- 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 the AI-powered prior authorization solution
- Work closely with healthcare providers to reduce administrative burdens and streamline workflows
- Manually process authorizations and oversee automated submissions for office visit referrals, procedures, pharmaceuticals, and more
- Review and verify insurance information and patient eligibility
- Gather medical documentation and information from healthcare providers
- Submit prior authorization requests to insurance companies following established protocols
- Monitor and track authorization requests for timely processing and resolution
- Respond to inquiries from providers, patients, and insurance companies about authorization status
- Maintain accurate records of authorization requests, approvals, and denials
- Collaborate with internal teams to resolve authorization issues and improve process efficiency
- Stay updated on insurance policies, regulations, and industry trends related to prior authorizations
- Help shape workflows as the role evolves into a hybrid operations and technology position
Requirements
What you’ll need- 4+ years of experience with prior authorization and billing in Oncology
- Experience with athenahealth and or NextGen
- Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield, etc.
- Experience with client relationships is a bonus
- Hands-on leadership experience, such as Team Lead, Supervisor, or informal leadership, is a bonus
- Experience engaging with C-suite executives is a bonus
- Detail-oriented, meticulous, and accurate
- Collaborative communication with providers, teammates, and cross-functional stakeholders
- Adaptable to manual workflows and AI-powered tools
- Empathetic and professional interactions with healthcare providers and patients
- Process-driven approach to established workflows and process improvement
Benefits
Comp & perks- Offers equity
- Comprehensive health insurance
- Competitive compensation
- Cutting-edge technology: Work directly with the latest advancements in generative AI and automation
- Ownership & growth with significant opportunities for career advancement
- Collaborative team with talented, passionate, and supportive colleagues