About the roleAs a Clinical Operations Specialist at Generator Health, you will play a critical role in ensuring the accuracy and integrity of our system’s prior authorization process. You'll bring your expertise in clinical data understanding to catch errors, and uphold the standards that our patients and providers depend on.This is a high-autonomy role where your attention to detail and ability to read, understand, and translate clinical data into results directly impacts patient access to treatment. Tens of thousands of patients move through our platform every week. You will work closely with our clinical intelligence team to support prior authorization, appeals, denial prediction and more. Your contributions will help us continuously improve the accuracy and reliability of our platform, whether decisions were made by AI, a third party, or our internal team.If you join, you will:Review a live queue of prior authorization cases coming through the platform, ensuring every decision meets clinical and operational standardsAudit AI outputs, third party reviews, and internal team decisions for accuracy, consistency, and complianceFlag errors and edge cases, documenting findings clearly for the clinical intelligence teamCollaborate cross-functionally to surface patterns and help refine the workflows and logic that power our platformExpand your knowledge across medical specialties as you work across a diverse range of casesContribute to improving the tools, standards, and processes that support patient access to treatmentWe’ll be most excited if you have:2+ years of hands-on experience in prior authorization, utilization management, clinical care coordination, scribing, or other roles that involve deep work with clinical documentationStrong familiarity with medical records and clinical notes, and comfort interpreting them accuratelyStrong written communication, with an ability to translate clinical complexity into clear, actionable findings for non-clinical teamsExceptional attention to detail and accuracyComfort and/or a strong interest in collaborating with product, engineering, and data science teammates on building new technologiesOur salary ranges are based on a number of factors, including qualifications, experience level, and geography.Generator Health is an equal opportunity employer and does not discriminate on the basis of race, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or
10 days ago