Categorization Specialist

Core Responsibilities

Product Categorization & Eligibility Determination

• Apply Truemed's Product Eligibility Framework to categorize products within assigned Eligibility Category Groups (ECGs) using a two-track system:
  • Track 1 (Category Matching): Evaluate products against existing category standards and comparable approved products; confirm alignment with established precedent.
  • Track 2 (New Products): Identify products requiring secondary review; escalate to Clinical Operations with detailed research gaps and recommendations for new categories.
• Obtain deep understanding of compliance standards (IRS Publication 502) to assess products against Section 213(d).
• Match products with approved eligibility categories.
• Flag products failing Section 213(d) criteria (general wellness, cosmetic, convenience, pharmaceutical, biologic).
• Approve products matching established category standards with clear precedent.
• Escalate borderline cases, novel mechanisms, or missing documentation to Clinical Operations.
• Reject products failing compliance standards.

Merchant Catalog Processing

• Process assigned merchant SKU lists (assigned 3 times a week) for specific specialties.
• Review merchant-submitted catalogs for new SKUs and products.
• Cross-reference products against approved category lists.
• Identify merchant SKU errors.
• Escalate new products to Track 1 or Track 2 evaluation process.

Daily Manual SKU Sweeps

• Conduct daily reviews of existing onboarded merchants' manually uploaded SKUs.
• Ensure compliance with established category standards and identify new product uploads or SKU variants.
• Review new SKU uploads from live merchants.
• Verify SKU compliance with category eligibility standards.
• Confirm correct eligibility category assignment in system.
• Ensure comparable items standards are applied where applicable.
• Document any compliance issues.

Requirements

• Clinically and compliance-minded background in health, clinical, nutrition, pharmacy, regulatory/compliance, benefits eligibility, medical claims, or product/catalog categorization.
• Comfortable reading regulatory guidance (e.g., IRS Publication 502, Section 213(d)) and applying it consistently to real products.
• Detail-obsessed with ability to review high volumes of SKUs without losing precision.
• Sound judgment under ambiguity: know when a product fits precedent, is borderline, or needs escalation; document reasoning clearly.
• Self-directed and reliable; manage own workflow to hit 2-business-day turnaround targets.
• Comfortable with structured, repeatable rules-based work.
• Independent Contractor (evaluated every 3 months), 30–40 hrs/week.