Remote Clinical Operations Specialist - Prior Authorization

Generator Health; United States; Remoto; USD 28.000 - 52.000; Tempo pieno

Descrizione del lavoro

Generator Health is seeking a Remote, full-time Clinical Operations Specialist to safeguard the accuracy of our prior authorization process. You will review live queues, audit AI outputs, and help PQ workflow improvements while handling diverse clinical cases.

Ideal candidates bring 2+ years in prior authorization, strong notes literacy, and outstanding attention to detail. You will collaborate with product, engineering, and data science teams to advance patient access to treatment.

Competenze

• 2+ years of hands-on experience in prior authorization or related roles.
• Strong familiarity with medical records and clinical notes.
• Ability to translate clinical complexity into actionable findings.
• Exceptional attention to detail and accuracy.

Mansioni

• Review a live queue of prior authorization cases to ensure decisions meet standards.
• Audit AI outputs, third-party reviews, and internal decisions for accuracy.
• Flag errors and edge cases with clear documentation for the clinical intelligence team.
• Collaborate across product, engineering, and data science to refine workflows.
• Expand knowledge across medical specialties while handling diverse cases.
• Contribute to improving tools, standards, and processes for patient access.

Conoscenze

Prior authorization

Clinical data

Auditing

Documentation

Cross-functional collaboration

Descrizione del lavoro

Generator Health is seeking a Remote, full-time Clinical Operations Specialist to safeguard the accuracy of our prior authorization process. You will review live queues, audit AI outputs, and help PQ workflow improvements while handling diverse clinical cases.

Ideal candidates bring 2+ years in prior authorization, strong notes literacy, and outstanding attention to detail. You will collaborate with product, engineering, and data science teams to advance patient access to treatment.