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.