Patient Access & Reimbursement Specialist

Cala Health, Inc.; United States; Remoto; USD 60.000 - 85.000; Tempo pieno

Descrizione del lavoro

Cala Health, Inc. is seeking a Therapy Access Specialist to guide new patients through the sales and reimbursement journey, educating them on Cala devices and therapy benefits. You will collaborate with field sales to coordinate shipments and gather documentation to determine medical necessity.

The role requires insurance expertise, familiarity with prior authorizations, and the ability to work cross-functionally while adhering to HIPAA and regulatory standards.

Competenze

• Bachelor’s degree preferred; high school diploma or equivalent required.
• 3–5 years of medical insurance experience, preferably at a medical device company.
• Knowledge of managed care, government payers, and DME coverage.
• Ability to build strong cross-functional relationships and manage reimbursement processes.
• Proficiency with Microsoft Word and Excel; Salesforce experience preferred.

Mansioni

• Guide new patients through the sales and healthcare reimbursement process.
• Educate patients about benefits and features of Cala Health devices and therapy.
• Coordinate with field sales representatives to support shipment processes.
• Collect medical documentation to establish medical necessity requirements.
• Investigate and determine insurance benefits and coverage eligibility.
• Identify provider restrictions and patient cost share responsibilities; communicate outcomes.
• Secure documentation for prior authorization and obtain approvals when needed.
• Document all interactions in the CRM in line with QA, regulatory and HIPAA guidelines.

Conoscenze

Medical insurance

Relationship building

Cross-functional collaboration

Problem solving

Attention to detail

Formazione

Bachelor's degree preferred

High school diploma required

Strumenti

Salesforce

Microsoft Word

Microsoft Excel

Descrizione del lavoro

Cala Health, Inc. is seeking a Therapy Access Specialist to guide new patients through the sales and reimbursement journey, educating them on Cala devices and therapy benefits. You will collaborate with field sales to coordinate shipments and gather documentation to determine medical necessity.

The role requires insurance expertise, familiarity with prior authorizations, and the ability to work cross-functionally while adhering to HIPAA and regulatory standards.