RCM Operations Specialist, Infusion (AI Platform)

present of AI; United States; Remote; USD 65,000 - 100,000; Full time

Job summary

Trellis AI is seeking an RCM Operations Specialist, Infusion (AI Platform) to become the in-house expert on infusion prior authorization and reimbursement. You will review real cases prepared by the AI system and confirm against payer policies and clinical notes, ensuring accuracy and compliance.

Strong writing and pattern-spotting skills help translate errors into rules and test cases. The role sits between clinical operations and engineering, translating reimbursement calls into actionable

Qualifications

• Several years of hands-on infusion or specialty pharmacy revenue cycle work.
• Careful reading of medical policies and differentiating fact from assumptions in charts.
• Ability to write clearly and to identify error patterns and convert them into rules and test cases.

Responsibilities

• Serve as in-house expert on infusion prior authorization and reimbursement.
• Review real AI-prepared cases and confirm against payer policy and clinical notes.

Skills

Infusion experience

Prior authorization

Revenue cycle

Policy interpretation

Clinical notes reading

Documentation accuracy

Job description

RCM Operations Specialist, Infusion (AI Platform)

The role is the in house expert on infusion prior authorization and reimbursement, checking real cases the AI system prepares and confirming each call against payer policy and clinical notes. A strong candidate brings several years of hands on infusion or specialty pharmacy revenue cycle work, reads medical policies with care, and can tell what the chart actually says from what was assumed. Clear short writing and the ability to spot error patterns and turn them into rules and test cases matter more than coding.

How it fits the AI era

The system drafts the intake, benefits and prior authorization work that people do by hand today, so the job shifts from producing that work to judging it. Human judgment stays central where payer rules are ambiguous, documentation is thin, or a case sits on an edge, and that judgment has to be written down so the product can learn from it. The role sits between the billing floor and the engineering team, translating real reimbursement calls into rules and examples.

How it builds AI experience

The person would gain direct experience reviewing AI output on live prior authorization and reimbursement cases, building answer keys with reasoning and sources, and shaping how payer rules and drug coverage criteria get encoded. That is practical grounding in how AI tools behave in healthcare operations and where they fail. Curiosity about AI in healthcare operations helps, and no coding is required.

Worth showing

• J codes and billing units
• Reading LCDs and NCDs
• Payer portals like Availity

This is our own read, written from the employer's posting and the company's Spotlight. The employer's posting is the source of truth for the role.

About Trellis AI

Artificial intelligence platform automating prior authorizations, clinical document intake, and medication access workflows for healthcare providers, per the company.