About the role
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
About Silna
Healthcare is obsessed with optimizing a broken system. We're making sure it never breaks.
Silna Health attacks the root cause of denied claims: the fragmented, incompatible systems that govern prior authorizations, eligibility verification, and benefit checks, turning workflows that used to take days into decisions made in minutes, before care is ever delivered.
We work across behavioral health, physical health, ambulatory care, and post-acute care, where administrative failure doesn't just cost money; it can delay or deny patient access entirely. We're backed by Accel and Bain Capital Ventures, and we're building fast.
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.
Aplyr's read
Silna Health is a cutting-edge healthcare technology firm, attracting professionals keen on enhancing patient care through digital innovation.
What's promising
- •Silna Health is at the forefront of digital healthcare innovation, focusing on tangible patient outcomes.
- •The company offers diverse roles, from AI Deployment Analyst to Product Designer, indicating a broad scope of operations.
- •Silna Health's commitment to digital solutions suggests strong growth potential in the evolving healthcare sector.
What to watch
- •Limited public information about company culture and employee satisfaction at Silna Health.
- •Navigating the complex healthcare technology landscape may pose strategic challenges.
- •Rapid scaling efforts could strain resources and affect operational efficiency.
Why Silna Health
- •Silna Health emphasizes patient outcomes, setting it apart from tech-focused competitors.
- •The company integrates AI and digital tools specifically for healthcare, a niche specialization.
- •Silna Health's roles span multiple disciplines, reflecting its comprehensive approach to healthcare technology.
Aplyr’s read is generated by AI from public sources. Was it useful?
About Silna Health
Silna Health is a healthcare technology company focused on improving patient outcomes through innovative digital solutions.