Authorization and Verification Research Specialist - Remote
1 day ago
Job description
Authorization and Verification Research Specialist
Remote | Full time | 40 hours/week
About the Role
We're looking for a detail-oriented insurance verification and prior authorization expert who thrives on research and problem-solving. In this role, you'll investigate payor requirements across insurance plans—digging into portals, policy updates, and submission processes—to uncover the specific steps needed to successfully submit prior authorizations and verify benefits.
You'll be our go-to researcher for understanding how different payors work, what documents they require, and how their processes vary across specialties. Your findings will directly enable our team to support healthcare providers and help patients access the care they need.
This role is ideal for someone who loves the investigative side of insurance work, stays current on payor policy changes, and wants to build expertise across a wide range of insurance plans.
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
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
Compensation & Benefits
Pay: $25-27/hour
Hours: 40 hours/week
Fully remote
All necessary devices and system access provided
Start date: ASAP
Why Join Silna Health?
Be part of a startup transforming healthcare administration. Your research will directly impact patients' ability to access timely care by helping providers navigate complex insurance requirements more effectively.
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