RCM Operations Specialist, Infusion (AI Platform)
Trellis AI, San Francisco, California +1
The role
Description
You will be our expert on infusion prior authorization and reimbursement. Our system reads referrals, clinical notes and payer policies, then prepares the work that intake and reimbursement teams do by hand today. Your job is to make sure that work is right. You will review real cases across our customers, catch what the system gets wrong and explain why. Then you turn that judgment into rules and test cases our engineers build on. You will work directly with the product and engineering team.
What you will do
- Review prior authorization and reimbursement cases for infusion customers, covering benefits, coverage, PA requirements, medical necessity, billing codes and units
- Check each decision against payer policies, Medicare LCDs and NCDs, payer portals and the patient's clinical documentation
- Build answer keys that record the correct outcome for real cases, with the reasoning and source behind each call