Authorization and Verification Research Specialist

Silna

Researching payor requirements across insurance plans to improve healthcare provider support. Solving complex submission processes to enhance patient care access.

Posted 7/29/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $25 - $27 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in prior authorization and insurance verification processes, with a strong ability to research and navigate payor-specific requirements. Capable of communicating findings effectively and adapting to fast-paced, evolving environments.

Highest-signal resume keywords

Prior Authorization ExperienceInsurance Verification ExperiencePayor Submission ProcessesStrong Research SkillsExceptional Attention to Detail

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Prior AuthorizationInsurance VerificationPayor Submission ProcessesCPT Code RequirementsPolicy Updates

Soft Skills

Strong Communication SkillsResilient Problem-SolverAbility to Adapt QuicklyAttention to DetailWillingness to Learn

Tools & Technologies

Payor PortalsPayor WebsitesDocumentation

Industry Keywords

Healthcare ClinicCommercial PlansState Medicaid Programs

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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

Benefits

Comp & perks

Fully remote
All necessary devices and system access provided