Authorization and Verification Research Specialist

Responsibilities

• Research and document prior authorization and benefit verification requirements across diverse payors
• Investigate payor-specific submission processes including required documents, portals, and CPT code requirements
• Stay informed on payor policy changes affecting authorization processes and benefit structures
• Navigate payor websites, newsletters, and representative communications to gather accurate information
• Validate information from multiple sources to determine credibility of payor guidance
• Work independently to solve ambiguous problems and communicate findings to stakeholders

Requirements

• Prior authorization and/or insurance verification experience at a healthcare clinic
• Deep familiarity with payor submission processes and insurance plan variations
• Strong research skills and comfort navigating payor portals and documentation
• Exceptional attention to detail and ability to spot authorization mistakes
• Experience working with multiple payors and understanding process variations
• Demonstrated ability to build or improve processes in evolving environments
• Strong communication skills and resilient problem-solving abilities

About the Company

Silna Health attacks the root cause of denied claims by fixing the fragmented systems that govern prior authorizations, eligibility verification, and benefit checks. Backed by Accel and Bain Capital Ventures, we are building tools to turn workflows that used to take days into decisions made in minutes.