Authorization and Verification Research Specialist

Authorization and Verification Research SpecialistRemote | Full time | 40 hours/weekAbout the RoleWe're looking for a detail-oriented insurance verification and prior authorization expert who thrives on research and problem-solving. In this role, you'll investigate payor requirements across insurance plans—digging into portals, policy updates, and submission processes—to uncover the specific steps needed to successfully submit prior authorizations and verify benefits.You'll be our go-to researcher for understanding how different payors work, what documents they require, and how their processes vary across specialties. Your findings will directly enable our team to support healthcare providers and help patients access the care they need.This role is ideal for someone who loves the investigative side of insurance work, stays current on payor policy changes, and wants to build expertise across a wide range of insurance plans.ResponsibilitiesResearch 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 updatesStay informed on payor policy changes, especially those affecting authorization processes and benefit structuresNavigate payor websites, newsletters, and representative communications to gather accurate, up-to-date informationValidate information from multiple sources and determine credibility of payor guidanceWork independently to solve ambiguous problems where established processes don't yet existCommunicate findings clearly to cross-functional stakeholders and adapt quickly to feedbackHandle tight deadlines and shifting priorities in a fast-paced startup environmentQualificationsRequired: Prior authorization and/or insurance verification experience at a healthcare clinic Deep familiarity with payor submission processes and how requirements vary across different insurance plansStrong research skills and comfort navigating payor portals, websites, and documentationExceptional attention to detail and ability to spot common authorization mistakesExperience working with multiple payors and understanding process variationsDemonstrated ability to build or improve processes when protocols don't existResilient problem-solver who thrives in ambiguous, evolving environmentsStrong communication skills and comfort asking for help when neededHumility and willingness to learn from mistakesCompensation & BenefitsPay: $25-27/hourHours: 40 hours/weekFully remoteAll necessary devices and system access providedStart date: ASAPWhy Join Silna Health?Be part of a startup transforming healthcare administration. Your research will directly impact patients' ability to access timely care by helping providers navigate complex insurance requirements more effectively.

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