Authorization and Verification Research Specialist

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🕒 March 27

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Velvet CARE sp. z o.o.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💳 Fintech

☁️ SaaS

Healthcare Insurance • Fintech • SaaS

Velvet CARE sp. z o. o. is a company dedicated to streamlining healthcare processes, specifically focusing on improving prior authorization and eligibility checks for healthcare providers. Through their platform, Silna, they empower providers to concentrate on patient care rather than administrative tasks. By handling prior authorizations and benefits checks, they facilitate efficient patient intake and ensure clinicians can deliver services seamlessly, ultimately enhancing job satisfaction and patient outcomes.

📋 Description

• Research and document prior authorization and benefit verification requirements across diverse payors (commercial plans, state Medicaid programs, etc.) • Investigate payor-specific submission processes: required documents, portals, fax numbers, CPT code requirements, and policy updates • Stay informed on payor policy changes, especially those affecting authorization processes and benefit structures • Navigate payor websites, newsletters, and representative communications to gather accurate, up-to-date information • Validate information from multiple sources and determine credibility of payor guidance • Work independently to solve ambiguous problems where established processes don't yet exist • Communicate findings clearly to cross-functional stakeholders and adapt quickly to feedback • Handle tight deadlines and shifting priorities in a fast-paced startup environment

🎯 Requirements

• Prior authorization and/or insurance verification experience at a healthcare clinic • Deep familiarity with payor submission processes and how requirements vary across different insurance plans • Strong research skills and comfort navigating payor portals, websites, and documentation • Exceptional attention to detail and ability to spot common authorization mistakes • Experience working with multiple payors and understanding process variations • Demonstrated ability to build or improve processes when protocols don't exist • Resilient problem-solver who thrives in ambiguous, evolving environments • Strong communication skills and comfort asking for help when needed • Humility and willingness to learn from mistakes

🏖️ Benefits

• Fully remote • All necessary devices and system access provided