Tennr · 1 week ago
Infusions & Specialty Pharmacy Documentation & Criteria Reviewer
United States
Full-time
Remote
Mid, Senior Level
$55K/yr - $57K/yr
4+ years expTennr is a company dedicated to improving the referral process in healthcare by ensuring timely and accurate patient information delivery. They are seeking a Documentation & Criteria Reviewer to enhance their documentation and criteria review team, focusing on assessing clinical documentation and ensuring alignment with payer standards.
Artificial Intelligence (AI)Health CareMedicalSoftware
Responsibilities
Review the model’s outputs to improve criteria determinations
Flag incorrect determinations, including false positives, false negatives, and unclear logic, with structured feedback
Compare documentation against Medicare, Medicaid, and commercial payer coverage policies
Analyze source materials (insurance policies, LCDs, etc.) to help validate qualification logic
Work closely with internal teams to refine prompting logic and improve documentation review standards
Maintain clear documentation of findings and contribute to process improvements
Qualification
Required
You have hands-on infusions/SP experience in roles such as intake, documentation review, case management, and clinical review
You are confident identifying when documentation meets or fails to meet payer requirements
You are comfortable reviewing insurance coverage policies and applying them to real-world cases
You are highly organized, detail-focused, and confident making policy-based decisions
You work well independently and value open communication within a remote team setting
Preferred
4+ years working in infusions/SP, ideally in intake, documentation review, case management, and clinical review
You are tech-savvy and comfortable using AI tools in your day-to-day work to improve accuracy and efficiency
Familiarity with Medicare, Medicaid, and commercial payer guidelines for infusions/SP
Understanding of HCPCS codes, NDCs, and common infusions/SP drug categories across therapeutic areas (e.g., neurology, inflammation and immunology, etc.)
Experience with audits, prior authorizations, and appeals is a strong plus
Familiarity with decision logic or rules-based platforms is helpful but not required
Benefits
New, spacious Chelsea office
Unlimited PTO
100% paid employee health benefit options
Employer-funded 401(k) match
Competitive parental leave
Free lunch! Plus a pantry full of snacks.
Company
Tennr
Tennr is a healthcare AI startup that provides an automation platform for medical documents.
201-500 employees
H1B Sponsorship
Tennr has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (7)
2024 (2)
Funding
Current Stage
Growth StageTotal Funding
$161MKey Investors
IVPLightspeed Venture PartnersAndreessen Horowitz
2025-06-18Series C· $101M
2024-10-22Series B· $37M
2024-03-26Series A· $18M
Leadership Team
Trey Holterman
CEO
Diego Baugh
Co-Founder & Chief of Product
Recent News
Foundation Capital
2025-12-31
Crunchbase News
2025-12-26
Company data provided by crunchbase