Remote AI Insurance Process Analyst (QA & Automation)

Silna; United States; A distancia; USD 60.000 - 70.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote role

401(k)

Unlimited PTO

Competitive benefits package

Descripción de la vacante

Silna Health is seeking an AI Insurance Process Specialist to map insurance workflows and QA AI outputs related to insurance rules. You will review AI outputs and translate payor requirements into executable workflows, joining research, QA, and task execution.

In this remote role, you’ll collaborate with healthcare operations teams to implement payor change requests, annotate documents, build decision trees, and measure improvements in accuracy and completion rates while maintaining clear

Formación

• Strong analytical skills and attention to detail.
• Ability to turn ambiguous requirements into clear steps and decision points.
• A systems mindset to understand how changes affect downstream work.
• Strong research skills and good judgment about what needs clarification.
• Clear written and verbal communication with precise instructions.
• Efficient task execution and ownership of outcomes.
• Curiosity about AI, healthcare operations, and insurance workflows.
• Ability to work independently in a remote environment.

Responsabilidades

• Evaluate AI performance and outputs.
• Review information from healthcare documents and AI actions to identify errors and gaps.
• Annotate documents and forms for AI training and QA.
• Label fields and map information to submission requirements; create practical examples.
• Build clear workflows and decision trees for processes.
• Translate insurance requirements into steps for prior authorization, eligibility, and benefits checks.
• Research payer rules, required documentation, submission methods, and follow-up procedures; document sources.
• Maintain up-to-date process guides, decision trees, and quality standards.
• Measure improvements and track metrics such as accuracy, completeness, and successful submissions.
• Execute on insurance change tasks timely; fulfill daily AI configuration changes.

Conocimientos

Analytical skills

Attention to detail

Systems mindset

Research skills

Clear communication

Efficient execution

Curiosity about AI

Remote collaboration

Descripción del empleo

Silna Health is seeking an AI Insurance Process Specialist to map insurance workflows and QA AI outputs related to insurance rules. You will review AI outputs and translate payor requirements into executable workflows, joining research, QA, and task execution.

In this remote role, you’ll collaborate with healthcare operations teams to implement payor change requests, annotate documents, build decision trees, and measure improvements in accuracy and completion rates while maintaining clear