AI Insurance Process Specialist

🔥 23 hours ago

🇺🇸 United States – Remote

💵 $60k - $70k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🤖 Artificial Intelligence

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Silna

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2023

🏥 Healthcare

☁️ SaaS

⚕️ Healthcare Insurance

💰 $22M Series A on 2025-04

Healthcare • SaaS • Healthcare Insurance

Silna is a care-readiness software company that provides an AI-powered platform to manage prior authorizations, benefit checks, and insurance monitoring for healthcare providers. It automates the entire prior authorization lifecycle (tracking, reminders, submissions, and follow-ups), performs specialty-specific benefit checks (coverage, accumulations, authorization requirements, and visit limits), and continuously monitors patient insurance status to flag lost or new coverage. Silna positions itself as a B2B SaaS solution that reduces administrative burden, increases payment certainty, and improves patient access to care; the company reports working with 1,000+ payors across all 50 states and supporting 250k+ patients, and is rated #1 in Prior Authorization on G2.

📋 Description

• Evaluate AI performance by reviewing information extracted from healthcare documents and actions taken by AI assistants during online and phone workflows • Identify errors, missing information, and cases requiring human review • Annotate documents and forms, label fields, map information to submission requirements, and create examples for AI development and evaluation • Build workflows and decision trees for prior authorization, eligibility verification, and benefit checks • Research payer rules, required documentation, submission methods, and follow-up procedures • Document sources and flag unclear or conflicting guidance • Create and update process guides, decision trees, and quality standards • Define and track metrics including accuracy, completeness, successful submissions, and human intervention frequency • Execute insurance change tasks accurately and fulfill the daily quota of AI configuration changes • Collaborate with healthcare operations teams and contribute to improving automation • Support healthcare organizations by simplifying prior authorizations, eligibility verification, and benefit checks

🎯 Requirements

• Strong analytical skills and attention to detail, with the ability to spot inconsistencies and investigate their causes • Ability to turn ambiguous requirements into clear steps, decision points, and exceptions • Systems mindset and understanding of workflow dependencies • Strong research skills and sound judgment about what is verified, assumed, or needs clarification • Clear written and verbal communication • Ability to document precise, repeatable instructions • Ability to execute tasks efficiently and own the outcome • Curiosity about AI, healthcare operations, and insurance workflows • Strong organizational skills • Ability to work independently and collaborate effectively in a remote environment • Applicants may come from technical or 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 • Must be legally authorized to work in the United States • Must complete employment eligibility verification upon hire

🏖️ Benefits

• A remote role with a collaborative, motivated team • The opportunity to build expertise at the intersection of healthcare and AI • Work that directly supports patient access to care • A competitive benefits package • 401(k) • Unlimited PTO

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