Therapy Access Specialist – Contractor
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Job Description
Therapy Access Specialist verifying insurance, eligibility, and authorizations for Cala Health’s non-invasive chronic-disease therapies. Supporting patient referrals and CRM documentation remotely.
Responsibilities:
- Provide operational support to the Therapy Access organization
- Contact patients and healthcare providers for documentation
- Verify active health insurance coverage by phone with payor representatives
- Use payor websites such as Availity and NaviNet to verify eligibility and submit prior authorizations
- Document all interactions and calls in the CRM system according to Quality Assurance, Regulatory and HIPAA guidelines
- Collaborate with Sales Support Representatives to transfer benefit verification and authorization data accurately and efficiently
- Enter new patient referrals into the CRM
- Contact new patient referrals for insurance confirmation
- Provide telephone and department support as needed
- Perform other related clerical duties as assigned
- Reports to the Associate Director, Therapy Access
Requirements:
- 3 to 5 years of medical insurance experience, preferably at a medical company
- High school diploma or equivalent required
- Bachelor’s degree is strongly preferred
- Experience in insurance benefits and eligibility
- Specific knowledge of health insurance plans, interpretation of benefits and prior authorization protocol
- General knowledge of the durable medical equipment (DME) coverage landscape is strongly recommended
- Strong computer skills, including CRM (Salesforce.com) and payor sites such as NaviNet and Availity
- Strong organizational skills and attention to detail
- Strong customer service skills
- Ability to communicate clearly and effectively, orally and in writing
- Ability to maintain confidentiality
- Applicants must be authorized to work in the United States on a full-time basis, or eligible for work authorization through a sponsorship path Cala Health can support
- Ability to stand, sit, talk, hear, reach, and use hands and fingers to operate a computer, telephone and keyboard
- Close vision required due to computer work
- Ability to sit or stand at a desk for extended periods
Benefits:
- All employees receive tools, training and mentoring needed to succeed
- Contractor (1099) position
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