Remote AI Insurance Process Analyst

Health Data Innovations, Inc.; United States; Remote; USD 60,000 - 70,000; Full time

Benefits offered by this job

Remote role

Competitive benefits package

401(k)

Unlimited PTO

Job summary

Silna Health is seeking an AI Insurance Process Specialist to map and QA insurance workflows, translate payor requirements into executable steps, and review AI outputs within healthcare operations. The role combines research, quality assurance, and task execution, with remote collaboration across teams.

You will evaluate AI performance, annotate documents, build workflows, and define metrics for accuracy and submissions, while advancing automation and process clarity in prior authorization,

Qualifications

• Experience translating ambiguous requirements into clear steps and decision points.
• Ability to annotate documents and map information to submission requirements.
• Strong research skills and judgment about verified vs assumed information.

Responsibilities

• Evaluate AI performance and review outputs within insurance workflows.
• Annotate documents and forms; label fields for payor submissions.
• Build clear workflows and decision trees for insurance processes.
• Translate insurance requirements into step-by-step processes (prior authorization, eligibility, benefits).
• Investigate payer rules, documentation, submission methods, and follow-up procedures.
• Maintain documentation and update process guides as rules change.
• Measure improvements (accuracy, completeness, submissions, human interventions).
• Execute on insurance change tasks daily and meet quotas for AI configuration changes.

Skills

Analytical thinking

Attention to detail

Documentation

Workflow mapping

Clear written and verbal communication

Independent with remote collaboration

Curiosity about AI

Tools

Python

SQL

AI tools

Job description

Silna Health is seeking an AI Insurance Process Specialist to map and QA insurance workflows, translate payor requirements into executable steps, and review AI outputs within healthcare operations. The role combines research, quality assurance, and task execution, with remote collaboration across teams.

You will evaluate AI performance, annotate documents, build workflows, and define metrics for accuracy and submissions, while advancing automation and process clarity in prior authorization,