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Infusions / Specialty Pharmacy Documentation Reviewer at Weekday AI. This role is for one of our clients. A leading AI lab advancing applied AI in healthcare is seeking . experienced professionals from the infusions and specialty pharmacy (SP) domain. to support its documentation and criteria review systems. The role focuses on ensuring that . payer authorization and medical necessity criteria. are accurately reflected and applied to clinical documentation. You will work with . AI-generated outputs. , validating determinations, reviewing them against payer coverage policies, and providing structured feedback to help refine automated decision-making standards.. This position is ideal for professionals with backgrounds in . intake, case management, documentation review, or clinical review. within the infusions or specialty pharmacy space who want to apply their expertise in a . flexible, high-impact environment. .. Key Responsibilities:. Review . AI-generated clinical determinations. for accuracy and compliance with payer criteria. . Identify and flag . inaccurate or unclear determinations. , providing structured feedback for model improvement. . Evaluate documentation against . Medicare, Medicaid, and commercial payer coverage policies. . . Analyze and interpret . insurance policies, LCDs, and related materials. to validate decision logic. . Collaborate with . AI and product teams. to enhance workflows and review standards. . Maintain organized records and contribute to continuous . process optimization. . . Qualifications:. Required:. Hands-on experience in . infusions or specialty pharmacy operations. (intake, documentation review, case management, or clinical review). . Strong understanding of . payer authorization processes. and . compliance requirements. . . Ability to interpret and apply . insurance coverage policies. to real-world clinical cases. . Highly detail-oriented, organized, and confident in making . policy-driven decisions. . . Comfortable working . independently in a remote setup. . . Preferred:. 4+ years of experience in the . infusions/specialty pharmacy. field. . Familiarity with . Medicare, Medicaid, and commercial payer guidelines. . . Working knowledge of . HCPCS codes, NDCs. , and common infusion drug categories (neurology, immunology, etc.). . Experience handling . prior authorizations, audits, or appeals. . . Tech-savvy and comfortable integrating . AI tools. into clinical review workflows.. Company Location: United States.