AI Insurance Process Specialist

Silna

. Evaluate AI performance by reviewing information extracted from healthcare documents and actions taken by AI assistants during online and phone workflows .

Posted 11/3/2026full-timeRemote • United StatesMid-LevelSenior💰 $60,000 - $70,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong analytical skills and attention to detail in evaluating AI performance and healthcare workflows. Proficient in documenting processes, creating decision trees, and collaborating with healthcare operations to enhance automation and efficiency.

Highest-signal resume keywords

Analytical SkillsHealthcare Administration ExperiencePrior Authorization KnowledgePython FamiliaritySQL Familiarity

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

AI Performance EvaluationDocument AnnotationWorkflow BuildingDecision Tree CreationMetric TrackingInsurance Change ExecutionProcess Documentation

Soft Skills

Attention to DetailClear CommunicationOrganizational SkillsCuriosity About AIIndependent Work

Tools & Technologies

AI ToolsHealthcare Documentation Systems

Industry Keywords

Prior AuthorizationEligibility VerificationBenefit ChecksHealthcare OperationsInsurance Workflows

Tech Stack

Tools & technologies

PythonSQL

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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