Job Overview
Location
Remote
Job Type
Full-time
Category
Operations
Date Posted
February 22, 2026
Full Job Description
đź“‹ Description
- • Silna Health is at the forefront of revolutionizing healthcare administration, focusing on streamlining the financial clearance process for specialty healthcare providers. Our innovative platform simplifies eligibility and benefit checks, and crucially, manages prior authorizations, allowing providers to dedicate more time to delivering exceptional patient care. We are a dynamic health technology company based in New York City, serving clients nationwide. We are seeking a highly motivated and enterprising Prior Authorization and Eligibility Specialist with a deep understanding of the Autism Spectrum Disorder (ASD) healthcare landscape to join our remote team.
- • In this pivotal role, you will be the primary point of contact for our valued ABA (Applied Behavior Analysis) healthcare provider clients, meticulously managing their prior authorization and related administrative tasks. This position offers a unique opportunity to not only excel in a specialized area of healthcare administration but also to contribute directly to the enhancement of our product. You will work in close collaboration with our Product and Engineering teams, providing invaluable insights derived from your daily interactions and expertise to help automate and optimize the prior authorization process.
- • Your responsibilities will encompass a broad range of critical functions designed to ensure seamless patient access to care:
- • **Client Collaboration and Information Gathering:** You will work hand-in-hand with ABA providers and their dedicated billing teams. This involves proactively collecting accurate and comprehensive patient demographic, clinical, and insurance information essential for successful authorization requests. Maintaining open and clear communication channels with clients is paramount to ensure all necessary documentation is gathered efficiently and accurately.
- • **Insurance Verification and Authorization Processing:** A core aspect of your role will be to liaunt directly with insurance payers. This includes verifying patient eligibility and benefits coverage, meticulously detailing aspects like deductibles, co-insurance, out-of-pocket maximums, and any benefit exclusions. You will then expertly navigate insurance portals and communicate directly with payer representatives to initiate, submit, and diligently follow up on prior authorization requests for ABA services.
- • **Timely Authorization Management:** Ensuring that authorizations are secured within the required timeframes is critical. You will be responsible for proactively tracking the status of all pending authorizations, following up with insurers to address any delays or requests for additional information, and providing supplementary documentation as needed to facilitate prompt approval.
- • **High-Volume Authorization Handling:** This role requires the ability to manage a significant caseload of prior authorizations simultaneously. You will be expected to develop and implement efficient workflows and processes to maintain a high standard of performance, ensuring accuracy and timeliness across all your assigned tasks.
- • **ABA-Specific Workflow Expertise:** A key requirement is to develop and maintain a deep understanding of ABA-specific clinical workflows. This includes familiarity with the process of creating treatment plans, understanding re-authorization requirements, and grasping the nuances of how ABA services are authorized by various insurance plans.
- • **Subject Matter Expertise Development:** You will become a recognized subject matter expert in ABA prior authorization workflows, particularly concerning the requirements and processes of major insurance companies. Your insights will be crucial in shaping our understanding and strategies.
- • **Product Improvement Contribution:** You will play an active role in the continuous improvement of the Silna Health platform. By sharing your firsthand knowledge and experiences with the Silna Product Engineering teams, you will help identify opportunities for automation, develop new features, and refine existing processes to make prior authorizations more efficient and less burdensome for providers.
- • **Cross-Functional Communication:** Effective communication is vital. You will need to communicate clearly and concisely with a diverse range of stakeholders, including ABA providers, their staff, insurance company representatives, and internal Silna Health teams.
- • **Commitment to Full-Time Engagement:** This is a full-time position requiring a commitment of 40 hours per week, ensuring consistent support for our clients and active participation in team initiatives.
- • This role is ideal for an individual who thrives in a fast-paced environment, possesses exceptional organizational skills, and is driven by a desire to make a tangible impact on patient access to essential healthcare services. Your dedication to accuracy, efficiency, and client satisfaction will be instrumental in Silna Health's continued success and our mission to transform healthcare administration.
🎯 Requirements
- • Minimum of 2 years of dedicated experience in completing prior authorizations specifically for ABA (Autism) services (not medication).
- • A strong understanding of insurance policies, benefits (including deductibles, co-insurance, out-of-pocket maximums, and exclusions), and ABA billing processes.
- • Proven experience with insurance payer portals and direct communication with payers (calling insurers).
- • Demonstrated ability to operate with a strong work ethic, exhibiting urgency, independence, exceptional organization, meticulous attention to detail, and effective multitasking capabilities.
🏖️ Benefits
- • Highly competitive hourly rate.
- • Opportunity to transition from a contractor role to a well-compensated full-time position.
- • Full-time position includes comprehensive benefits and potential equity in the company.
- • Fully remote work environment.
- • A meaningful opportunity to significantly impact patients' ability to access critical ABA care.
Skills & Technologies
Remote
About Silna Health
Silna Health is a healthcare technology company that builds cloud-native software for value-based care providers. Its platform automates administrative workflows, aggregates clinical and claims data, and delivers analytics to help medical groups, IPAs, and health plans improve quality outcomes, reduce costs, and manage risk-based contracts across Medicare Advantage, Medicaid, and commercial populations.
