Therapy Access Specialist – Contractor

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

📋 Description

• Deliver operational assistance to the Therapy Access organization

• Reach out to patients and healthcare providers for required documentation

• Confirm active health insurance coverage via phone communication with payor representatives

• Utilize payor websites like Availity and NaviNet to verify eligibility and submit prior authorizations

• Record all interactions and calls in the CRM system in accordance with Quality Assurance, Regulatory, and HIPAA guidelines

• Work closely with Sales Support Representatives to accurately and efficiently transfer benefit verification and authorization information

• Input new patient referrals into the CRM

• Contact new patient referrals to confirm insurance details

• Provide telephone and departmental support as required

• Execute additional clerical tasks as assigned

• Reports to the Associate Director, Therapy Access

⛳️ Requirements

• 3 to 5 years of experience in medical insurance, preferably within a medical organization

• High school diploma or equivalent is mandatory

• Bachelor’s degree is highly preferred

• Background in insurance benefits and eligibility is required

• Specific knowledge of health insurance plans, benefit interpretation, and prior authorization processes

• General understanding of the durable medical equipment (DME) coverage landscape is strongly recommended

• Proficient computer skills, including experience with CRM (Salesforce.com) and payor sites such as NaviNet and Availity

• Excellent organizational skills and attention to detail

• Strong customer service abilities

• Capability to communicate clearly and effectively, both verbally and in writing

• Ability to maintain confidentiality

• Candidates must be authorized to work in the United States on a full-time basis, or eligible for work authorization through a sponsorship path that Cala Health can support

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

• Close vision is necessary due to computer work

• Capacity to sit or stand at a desk for prolonged periods

🏝️ Benefits

• All employees receive the necessary tools, training, and mentoring to thrive

• This is a Contractor (1099) position