Clinical Operations Specialist

Responsibilities

• Review a live queue of prior authorization cases to ensure decisions meet clinical and operational standards
• Audit AI outputs, third party reviews, and internal team decisions for accuracy and compliance
• Flag errors and edge cases, documenting findings for the clinical intelligence team
• Collaborate cross-functionally to surface patterns and refine platform workflows and logic
• Expand knowledge across medical specialties through diverse case management
• Contribute to improving tools and processes that support patient access to treatment

Requirements

• 2+ years of experience in prior authorization, utilization management, clinical care coordination, or scribing
• Strong familiarity with medical records and clinical notes
• Ability to interpret clinical documentation accurately
• Strong written communication skills to translate clinical complexity for non-clinical teams
• Exceptional attention to detail and accuracy
• Interest in collaborating with product, engineering, and data science teams

About the Company

Generator Health focuses on improving the accuracy and reliability of prior authorization, appeals, and denial prediction to ensure patients and providers have seamless access to treatment.