Role Description
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 timely 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 and 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
Qualifications
• 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 CentralReach and Rethink
Benefits
• 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
Requirements
• Prior Authorization (services, not medication): 2 years (Required)
• Insurance verification: 1 year (Required)
• ABA/Autism prior authorization: 2 years (Required)
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