Therapy Access Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the primary contact for new patients during the sales process to acquire Cala Health products and services.

• Assist new patients in navigating the sales and healthcare reimbursement procedures.

• Cultivate and maintain a thorough understanding of company products and their applications.

• Inform prospective patients about the advantages and features of Cala Health devices and therapies.

• Collaborate with field sales representatives to streamline the sales process and facilitate shipments.

• Reach out to physicians and clinicians to gather necessary documentation and ascertain medical necessity requirements.

• Explore insurance benefits and eligibility for coverage.

• Evaluate clinical records to establish medical necessity qualifications.

• Identify provider limitations, co-pays, deductibles, and other patient cost-sharing obligations; communicate results and gather payments.

• Obtain prior-authorization documentation and pursue authorizations when necessary.

• Handle incoming calls from new patients regarding the status of their orders.

• Collaborate with Veteran Administration facilities to advocate for and process Cala Health devices and therapies.

• Update and maintain databases for sales order processing and claim-submission preparation.

• Record interactions and calls in the CRM system in compliance with Quality Assurance, Regulatory, and HIPAA standards.

• Uphold company objectives, policies, procedures, Good Manufacturing Practices, and FDA regulations.

• Report directly to the Associate Director of Therapy Access; no direct reports.

• Undertake additional responsibilities as assigned.

• Work various shifts based on business requirements.

⛳️ Requirements

• A high school diploma or equivalent is mandatory.

• A Bachelor's degree is highly preferred.

• 3-5 years of experience in medical insurance, preferably within a medical device company.

• Familiarity with the managed care sector, including government payers.

• Understanding of healthcare plans and benefits associated with durable medical equipment.

• Capability to forge and sustain strong relationships with cross-functional teams and external partners.

• Expertise in reimbursement processes and revenue cycle management.

• Ability to work collaboratively within a team structure and effectively delegate tasks to appropriate team members.

• Strong problem-solving skills, attention to detail, and the ability to prioritize tasks.

• Proficiency in Microsoft Word and Excel.

• Experience with Salesforce is advantageous but not required.

• Candidates must be authorized to work in the United States on a full-time basis or eligible for work authorization through a sponsorship path supported by Cala Health.

• Capability to sit or stand at a desk for extended durations.

• Ability to stand, sit, talk, hear, reach, and use hands and fingers to operate a computer, telephone, and keyboard.

• Close vision capability due to computer-related tasks.

🏝️ Benefits

• All employees are provided with the tools, training, and mentoring necessary for success.

• Opportunity to travel as needed for training purposes.