silnahealth.com - AI Insurance Process Specialist

• * Investigate payer rules, required documentation, submission methods, and follow-up procedures. Document sources and flag unclear or conflicting guidance. • *Maintain practical documentation. • * Create and update process guides, decision trees, and quality standards as requirements change. • *Measure improvements. • * Help define and track metrics such as accuracy, completeness, successful submissions, and the frequency of human intervention. • *Execute on insurance change tasks in a timely manner. • * Fulfill daily quota of AI configuration changes in our system accurately. • ● Strong analytical skills and attention to detail, with the ability to spot inconsistencies and • investigate their causes. • ● The ability to turn ambiguous requirements into clear steps, decision points, and exceptions. • ● A systems mindset: you understand how steps in a workflow connect and how a change in • one area affects downstream work. • ● Strong research skills and sound judgment about what is verified, what is assumed, and • what needs clarification. • ● Clear written and verbal communication, including the ability to document precise, • repeatable instructions. • ● Ability to execute on tasks in an efficient manner, owning the outcome. • ● Curiosity about AI, healthcare operations, and insurance workflows. • ● Strong organizational skills and the ability to work independently and collaborate effectively in a remote environment. • We welcome applicants from technical and nontechnical backgrounds, including recent graduates.Experience with healthcare administration, prior authorization, and insurance verification is helpful. Familiarity with Python, SQL, or AI tools is a bonus. • Silna Health helps healthcare organizations prevent administrative issues before care is delivered. We simplify prior authorizations, eligibility verification, and benefit checks so providers can spend less time navigating insurance requirements and patients can access care sooner. We work across behavioral health, physical health, ambulatory care, and post-acute care, and are backed by Accel and Bain Capital Ventures.