Crossword Genius

More nuts in his hoard, arranged as piles (12)

Ross

I believe the answer is:

haemorrhoids

'piles' is the definition.
(I know this)

'more nuts in his hoard arranged' is the wordplay.
'nuts' indicates anagramming the letters (nuts can mean crazy).
'in' is an insertion indicator.
'arranged' indicates an anagram.
'more' anagrammed gives 'emor'.
'his'+'hoard'='hishoard'
'hishoard' anagrammed gives 'harhoids'.
'emor' put into 'harhoids' is 'HAEMORRHOIDS'.

'as' is the link.

I've seen this clue in The Sunday Times.
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