Note: The job is a remote job and is open to candidates in USA. Silna Health is a startup transforming healthcare administration, seeking a detail-oriented insurance verification and prior authorization expert. The role involves researching payor requirements across insurance plans to support healthcare providers and help patients access necessary care.
Responsibilities
- Research and document prior authorization and benefit verification requirements across diverse payors (commercial plans, state Medicaid programs, etc.)
- Investigate payor-specific submission processes: required documents, portals, fax numbers, CPT code requirements, and policy updates
- Stay informed on payor policy changes, especially those affecting authorization processes and benefit structures
- Navigate payor websites, newsletters, and representative communications to gather accurate, up-to-date information
- Validate information from multiple sources and determine credibility of payor guidance
- Work independently to solve ambiguous problems where established processes don't yet exist
- Communicate findings clearly to cross-functional stakeholders and adapt quickly to feedback
- Handle tight deadlines and shifting priorities in a fast-paced startup environment
Skills
- Prior authorization and/or insurance verification experience at a healthcare clinic
- Deep familiarity with payor submission processes and how requirements vary across different insurance plans
- Strong research skills and comfort navigating payor portals, websites, and documentation
- Exceptional attention to detail and ability to spot common authorization mistakes
- Experience working with multiple payors and understanding process variations
- Demonstrated ability to build or improve processes when protocols don't exist
- Resilient problem-solver who thrives in ambiguous, evolving environments
- Strong communication skills and comfort asking for help when needed
- Humility and willingness to learn from mistakes
Benefits
- Fully remote
- All necessary devices and system access provided
Company Overview
Introducing the industry's first Care Readiness Platform. It was founded in 2023, and is headquartered in New York, New York, USA, with a workforce of 11-50 employees. Its website is https://www.silnahealth.com/.