Prior Authorization & Verification Researcher (Remote)

Silna Health, Inc.; United States; Remote; USD 34,000 - 37,000; Full time

Benefits offered by this job

Fully remote

Provided devices

ASAP start

Job summary

Silna Health, Inc. is seeking a detail-oriented Authorization and Verification Research Specialist for a fully remote, full-time role.

You will investigate payor requirements, verify benefits, and document submission processes across commercial plans and Medicaid, enabling providers to obtain authorizations quickly and accurately. Ideal candidates excel at research, stay current on payer policy changes, and can navigate portals and documents with precision.

Qualifications

• Prior authorization and/or insurance verification experience in a healthcare clinic.
• Deep familiarity with payor submission processes and plan variations.
• Strong research skills and comfort navigating payor portals and documentation.
• Exceptional attention to detail and ability to spot authorization mistakes.
• Experience working with multiple payors and understanding process variations.
• Ability to build or improve processes when protocols don't exist.
• Resilient problem-solver in ambiguous, evolving environments.
• Strong communication skills and comfort asking for help when needed.
• Humility and willingness to learn from mistakes.

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 experience

Insurance verification

Research skills

Attention to detail

Communication

Problem-solving

Job description

Silna Health, Inc. is seeking a detail-oriented Authorization and Verification Research Specialist for a fully remote, full-time role.

You will investigate payor requirements, verify benefits, and document submission processes across commercial plans and Medicaid, enabling providers to obtain authorizations quickly and accurately. Ideal candidates excel at research, stay current on payer policy changes, and can navigate portals and documents with precision.