ABA Prior Authorization Specialist Remote, Operations

Silna Health () is a health technology company that handles eligibility & benefit checks and prior authorizations for specialty healthcare providers. Our mission is to streamline how providers financially clear patients for care, so providers can spend more time delivering exceptional care. We are based in New York City and work with customers across the country.

Silna Health is looking for an enterprising prior authorization and eligibility expert to work closely with our customers - ABA (Autism) healthcare providers - and complete prior authorizations and related tasks on their behalf. This is a unique role, as you will also be working closely with the Silna Product team to automate parts of the prior authorization process.

• Work closely with ABA providers and their billing team 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-specific workflows, including creating treatment plans, re-authorization
• Become a subject matter expert in ABA 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

• The ideal candidate will have a strong understanding of insurance policies and ABA billing processes
• 3+ years of experience completing prior authorizations for ABA services specifically (not medications), with 2+ years of experience in ABA/Autism doing prior authorizations. Strong understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions
• Have familiarity with payor portals and experience calling payors
• Have a strong work ethic: operate with urgency, work independently, be highly organized, detailed oriented and multi-task effectively
• Nice to have:
  Be familiar with providers software, including Electronic Medical Record Systems (EMR/EHR) like Central Reach and Rethink

• An highly competitive hourly rate
• Chance to move from contractor to a well compensated full time position, which includes benefits and equity in the company
• Remote role
• Best of all, a chance to make an impact on patients ability to access care

To apply, please attach a resume and any other relevant details about your background. Please do not apply if you don't have the criteria required.

Job Type: Full-Time

Experience:

• Prior Authorization (services, not medication): 2 years (Required)
• Insurance verification: 1 year (Required)
• ABA/Autism prior authorization: 2 years (Required)

Work Location:
Remote