Silna

Documentation Specialist

• Write and maintain clear, standardized documentation of payor requirements, submission processes, and authorization workflows
• Build and refine checklists for prior authorization and benefit verification submissions across payors, ensuring consistent format and terminology
• Annotate and tag source materials (payor policies, portal captures, requirement documents) with structured, consistent labels for internal reference and systems use
• Edit and standardize documentation drafted by others so all materials follow a consistent style, structure, and level of detail
• Keep documentation current as payor policies change, with clear version tracking
• Proofread and quality-check all documentation for accuracy, consistency, and clarity before it goes live
• Research and validate 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processes (required documents, portals, fax numbers, CPT code requirements) when existing documentation is unclear, outdated, or missing
• Validate information from multiple sources and assess the credibility of payor guidance before it's documented

Payor Process and Documentation Specialist

Research Analyst

• 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

Authorization and Verification Research Specialist

Authorization Specialist

• Work closely with ABA / behavioral health providers and their billing teams to collect accurate patient information and communicate authorization decisions
• Work with insurers to verify patient eligibility and benefits, and expediently complete prior authorizations using insurance portals or calling insurers directly. Ensure authorization is approved in a timeline manner by following up with insurers and providing additional information
• Be responsible for handling multiple prior authorizations simultaneously and create process to ensure top of the line performance
• Understand ABA- and other behavioral health-specific workflows, including creating treatment plans, re-authorization
• Become a subject matter expert in behavioral health prior authorization workflows for large insurers
• Work closely with Silna Product/Engineering teams to share learnings about the prior authorization process to help automate parts of it
• Communicate effectively across multiple stakeholders
• Be willing to work 40 hours per week

Payor Process and Documentation Specialist

Authorization and Verification Research Specialist

ABA Authorization Specialist