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Silna · 2 months ago

ABA Prior Authorization Specialist

United States

Full-time

Remote

Mid Level

$26/hr - $28/hr

3+ years exp

Silna Health is a health technology company focused on streamlining eligibility and benefit checks for specialty healthcare providers. They are seeking an enterprising prior authorization and eligibility expert to work closely with ABA healthcare providers to manage prior authorizations and collaborate with the Silna Product team on automation efforts.

Artificial Intelligence (AI)Health CareInformation Technology

Responsibilities

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

Qualification

ABA prior authorizationInsurance policies knowledgePayor portals familiarityEMR/EHR software knowledgeWork ethic

Required

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

Prior Authorization (services, not medication): 2 years (Required)

Insurance verification: 1 year (Required)

ABA/Autism prior authorization: 2 years (Required)