Remote Prior Authorization & Verification Researcher

Silna; United States; Remote; USD 34,440 - 37,195; Full time

Benefits offered by this job

Fully remote

Equipment provided

ASAP start

Job summary

Silna Health is seeking an Authorization and Verification Research Specialist to remotely investigate payor requirements for prior authorizations and benefit verification. You will research, document, and validate payor submission processes across plans, ensuring accurate guidance for clinicians and patients.

The role emphasizes detailed payor policy tracking, independent problem solving, and clear communication with stakeholders in a fast-paced startup setting.

Qualifications

• Required: 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.

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

Insurance verification

Payor submission

Research skills

Attention to detail

Process improvement

Cross-functional communication

Ambiguity navigation

Continuous learning

Job description

Silna Health is seeking an Authorization and Verification Research Specialist to remotely investigate payor requirements for prior authorizations and benefit verification. You will research, document, and validate payor submission processes across plans, ensuring accurate guidance for clinicians and patients.

The role emphasizes detailed payor policy tracking, independent problem solving, and clear communication with stakeholders in a fast-paced startup setting.