RCM Operations Specialist, Infusion (AI Platform)

Description
About Trellis
Trellis builds AI that handles intake, benefits, prior authorization and reimbursement for infusion and specialty pharmacy providers, so patients start therapy faster and providers get paid for it.
The role
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
Find patterns in errors and write them up clearly for product and engineering, with examples
Keep a working library of payer rules, drug coverage criteria and billing conventions up to date
Learn how customer intake and reimbursement staff handle edge cases, and bring those conventions into the product
Review early output during customer onboarding and flag risk before it reaches a claim
What you bring
3+ years in infusion or specialty pharmacy revenue cycle, such as prior authorization, benefits verification, billing, denials or appeals
Working knowledge of medical versus pharmacy benefit, buy and bill, HCPCS J codes, administration CPT codes, NDC to billing unit conversion and modifiers
Comfort reading LCDs, NCDs and commercial medical policies and applying them to a specific patient
Experience with payer portals and PA tools such as Availity or CoverMyMeds, and pharmacy or infusion systems such as CPR+ or WellSky
Careful judgment. You know the difference between what the chart says and what someone assumed
Clear writing. You can explain a denial risk in two sentences to someone who has never billed a claim
Nice to have
A CPC, CPB, CRCS or similar certification, or a pharmacy technician or nursing background
Experience at a home infusion provider, ambulatory infusion center or specialty pharmacy
Experience with biologics, IVIG and other high cost therapies across Medicare, Medicaid and commercial plans
Curiosity about how AI can change healthcare operations. No coding required

Experience
3+ years

Work arrangement
Yes