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Prior Authorization Specialist - Health Systems/Post-Acute

100% Remote Full-time Open now

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 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.

What You’ll Do:

As a Prior Authorization Specialist at Ascertain, you will play a critical role in our AI-powered prior authorization solution. You’ll collaborate closely with operations, leadership, and product teams to help shape how prior authorization is transformed through automation and AI.

You’ll partner with healthcare providers—particularly in hospital and post-acute settings—to reduce administrative burden and streamline complex workflows. Day-to-day responsibilities include both manual processing and oversight of automated submissions across services such as procedures, referrals, and medications.

  • 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

What You'll Need:

  • 4+ years of prior authorization experience, including hospital-based and/or post-acute care settings (required)

  • Hands-on experience working in Epic (required)

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

  • Familiarity with major payors (UnitedHealthcare, Aetna, BCBS, etc.)

  • Strong understanding of complex care transitions and authorization nuances across care settings

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 leveraging new AI-powered tools, adjusting quickly as processes evolve.

  • Empathetic. You are attuned to the needs of healthcare 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.

  • 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.

Why Ascertain? Make a real difference: Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI!

Apply To This Job

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