Therapy Access Specialist
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Job Description
Therapy Access Specialist guiding U.S. patients through Cala Health device sales, reimbursement, and authorization. Coordinating clinicians, insurers, field sales, and shipment processing.
Responsibilities:
- Guide new patients through the sales and healthcare reimbursement process
- Develop and maintain superior knowledge of company products and their use
- Educate potential patients about benefits and features of Cala Health devices and therapy
- Partner with assigned field sales representatives to coordinate the sales process and support shipment
- Contact physicians and clinicians to collect medical documentation and identify medical necessity requirements
- Investigate patient insurance benefits and coverage eligibility
- Review patient clinical records to determine medical necessity eligibility
- Identify provider restrictions, co-pays, deductibles, and other patient cost-share responsibilities; communicate outcomes and collect payments
- Secure document requirements for prior authorization and seek authorizations when required
- Take inbound calls from new patients regarding order status
- Work with Veteran Administration facilities to promote and process Cala Health devices and therapy
- Update and maintain database platforms for sales order processing and claim submission preparation
- Document interactions and calls in the CRM system in accordance with Quality Assurance, Regulatory, and HIPAA guidelines
- Support company goals, policies, procedures, Good Manufacturing Practices, and FDA regulations
- Perform additional duties as assigned
- Work variable shifts based on business needs
Requirements:
- High school diploma or equivalent required
- Bachelor’s degree is strongly preferred
- Minimum 1 years’ experience in a Customer Service or related type role
- Knowledge of managed care industry including government payers
- Understanding of healthcare plans and benefits related to durable medical equipment
- Ability to build and maintain strong relationships with cross-functional teams and external partners
- Proficient in aspects of reimbursement and revenue cycle management
- Ability to work collaboratively in a team structure and responsibly delegate next steps to appropriate team members
- Effective problem-solving abilities, attention to detail and ability to prioritize
- Ability to travel as required for training
- Proficiency in Microsoft Word and Excel
- Applicants 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 is able to support
- Experience using Salesforce is preferred but not required
Benefits:
- Cala Health company stock options
- Robust benefits package
- Tools, training and mentoring to succeed
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