[Remote] Authorization and Verification Research Specialist

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