Authorization and Verification Research Specialist

About the role

We are looking for a detail‑oriented specialist who will research and document prior‑authorization and benefit‑verification requirements across a wide range of insurance payors. The role involves digging into payor portals, policy updates, and submission processes to enable our team to support healthcare providers and help patients access care.

Key responsibilities

• Research and document prior‑authorization and verification requirements for commercial plans, state Medicaid programs, and other payors.
• Investigate payor‑specific submission processes, including required documents, portals, fax numbers, CPT code rules, and policy updates.
• Stay current on payor policy changes that affect authorization and benefit structures.
• Validate information from multiple sources and assess the credibility of payor guidance.
• Work independently to solve ambiguous problems where established processes do not yet exist.
• Communicate findings clearly to cross‑functional stakeholders and adapt quickly to feedback.

Required profile

• Prior authorization or insurance verification experience in a healthcare setting.
• Deep familiarity with payor submission processes and variations across insurance plans.
• Strong research skills and comfort navigating payor portals, websites, and documentation.
• Exceptional attention to detail and ability to identify common authorization mistakes.
• Proven ability to build or improve processes when protocols are missing.
• Resilient problem‑solver who thrives in ambiguous, fast‑moving environments.

What we offer

• Hourly pay of $25‑27.
• Full‑time, 40‑hour week, fully remote.
• All necessary devices and system access provided.
• Immediate start date.