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/.