Authorization and Verification Research Specialist

The role

You will research and document prior authorization and benefit verification requirements across diverse payors. You will investigate payor-specific submission processes and stay informed on policy changes.

What you will do

• Research and document prior authorization and benefit verification requirements across diverse payors
• Investigate payor-specific submission processes including required documents, portals, fax numbers, CPT code requirements, and policy updates
• Stay informed on payor policy changes affecting authorization processes and benefit structures
• Navigate payor websites, newsletters, and representative communications to gather information
• Validate information from multiple sources and determine credibility of payor guidance
• Work independently to solve ambiguous problems where established processes do not yet exist
• Communicate findings clearly to cross-functional stakeholders
• Handle tight deadlines and shifting priorities in a fast-paced startup environment

Required qualifications

• 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 do not 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

About the company

Silna Health attacks the root cause of denied claims by addressing fragmented systems that govern prior authorizations, eligibility verification, and benefit checks. They are backed by Accel and Bain Capital Ventures.