Therapy Access Specialist

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

📋 Description

• Assist new patients through the sales and healthcare reimbursement journey.

• Cultivate and maintain in-depth knowledge of company products and their application.

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

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

• Reach out to physicians and healthcare professionals to obtain medical documentation and ascertain medical necessity criteria.

• Evaluate patient insurance benefits and coverage eligibility.

• Analyze patient clinical records to verify medical necessity eligibility.

• Identify provider restrictions, co-pays, deductibles, and other patient cost-sharing responsibilities; communicate findings and collect payments.

• Gather document requirements for prior authorization and pursue authorizations as necessary.

• Handle incoming calls from new patients regarding their order status.

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

• Update and manage database systems for sales order processing and claims submission preparation.

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

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

• Perform additional tasks as assigned.

• Work flexible shifts based on business requirements.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• Bachelor’s degree is highly preferred.

• A minimum of 1 year of experience in a Customer Service or a related role is required.

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

• Understanding of healthcare plans and benefits pertaining to durable medical equipment.

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

• Proficiency in reimbursement processes and revenue cycle management.

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

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

• Willingness to travel as necessary for training purposes.

• Proficient in Microsoft Word and Excel.

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

• Experience with Salesforce is preferred but not mandatory.

🏝️ Benefits

• Cala Health company stock options.

• Comprehensive benefits package.

• Resources, training, and mentoring to ensure success.