ABA Prior Authorization Specialist Remote, Operations

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.

Silna is looking for an enterprising prior authorization and benefits verifications expert to work closely with our customers - ABA (Autism), Mental Health, IOP, and Psych Testing providers - and complete these administrative 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 verification and authorization processes.

• 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

• The ideal candidate will have a strong understanding of insurance policies and ABA billing processes
• 2+ years of experience completing prior authorizations for ABA (preferred) or other behavioral health services. 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

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