The work
You own the reviewer console — every Case that comes through Approva crosses your screen before submission. You build the audit playbook against payer-specific medical necessity criteria. You sit alongside the first ASC pre-cert teams during onboarding and run live demos with prospective customers. You capture every denial reason as training signal. By month six, you've defined the reviewer team Approva hires as volume grows — and you lead it.
Who you are
- CPMA, CASCC, or equivalent certification with surgical coding experience. Or RN with five or more years of utilization-management or payer-side prior authorization experience.
- Eight or more years working prior auth and denials at a high-volume facility — ASC, surgical hospital, or large multi-specialty group.
- Comfortable in front of customers. The senior reviewer demos the product, not a salesperson.
- Comfortable with software. Approva is technical — you work daily with engineers, file tickets, and shape the product roadmap.
- Bay Area-based or willing to come for working sessions monthly.
What you get
- Founder-tier equity. Specifics in conversation; this is an employee-number-one role.
- Direct work with the founder. No layer of managers between you and the product.
- The reviewer team you go on to lead.
- Cash compensation that reflects your seniority. Healthcare benefits.
The team you join
Approva is small and stays small. The team we're building is half engineering — type systems, document understanding, payer routing — and half certified clinical operators who know prior auth and denials cold. Bay Area or remote. Senior people only. No rotational programs, no junior pipeline, no “we'll figure it out later” hires.
How we hire
A thirty-minute call with the founder. Then a working session with a de-identified Approva Case — we send you the chart, you review the assembled Packet, we discuss what you'd change. If both sides are still in, terms in writing within a week. We don't run whiteboard interviews, multi-round panels, or take-home tests longer than two hours. Senior reviewers shouldn't have to audition like junior candidates.