Therapy Access Specialist

Cala Health; United States; Remote; USD 60,000 - 85,000; Full time

Job summary

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.

Qualifications

• 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.

Responsibilities

• 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.

Skills

Medical insurance

Relationship building

Cross-functional collaboration

Problem solving

Attention to detail

Education

Bachelor's degree preferred

High school diploma required

Tools

Salesforce

Microsoft Word

Microsoft Excel

Job description

At Cala, we’re working to free people from the burden of chronic disease. We began by creating the first non-invasive prescription therapy for hand tremor. After years of careful fine-tuning and improvements, we recently released kIQ® Plus, our most sophisticated therapy yet. Our products have empowered thousands of people to get back to their lives with confidence and ease.

But we won’t stop there. Our pioneering technology can be applied across neurology, cardiology, and beyond. It’s all part of our mission to help people in their struggle with chronic disease. We’re only just getting started

About this Position

Cala Health’s Therapy Access Specialist is the main point of contact for new patients throughout the sales process to obtain Cala Health products and services. Responsibilities include, but are not limited to, contacting patient and healthcare providers for documentation, verifying insurance benefits and securing authorizations. This role requires specific knowledge of health insurance plans, interpretation of benefits and prior authorization protocol. General knowledge of durable medical equipment (DME) coverage landscape is strongly recommended. The Therapy Access Specialist reports to the Associate Director, Therapy Access and has no direct reports.

Specific 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 its therapy
• Partner with assigned field sales representatives to coordinate the sales process to support the shipment process
• Contact with physicians and clinicians to collect medical documentation to identify medical necessity requirements
• Investigate patient’s 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 to provide information about status of order
• 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 all interactions and calls into the customer relationship management (CRM) system in accordance with Quality Assurance, Regulatory and HIPAA guidelines
• Support company goals and objectives, policies and procedures, Good Manufacturing Practices, and FDA regulations
• Additional duties as assigned
• Shift times may vary based on business needs

Skills and Experience

• Bachelor’s degree is strongly preferred; High school diploma or equivalent required
• 3-5 years of medical insurance experience, preferably at a medical device company
• 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
• Demonstrates effective problem-solving abilities, attention to detail and ability to prioritize
• Ability to travel as required for training
• Proficiency in Microsoft Word and Excel.
• Experience using Salesforce is preferred but not required

Physical Demands

• While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach and use hands and fingers to operate a computer, telephone and keyboard
• Specific vision abilities required by this job include close vision requirements due to computer work
• Ability to sit or stand at a desk for extended periods of time

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. Sponsorship decisions are made individually based on role, timeline, and cost considerations, and are not guaranteed.

Cala Health believes our success is based on diversity of people, teams and thinking. We offer all employees the tools, training and mentoring they need to succeed. Our selection process is driven by the key requirements for the role rather than bias or discrimination on the basis of a candidate’s sex, gender identity, age, marital status, veteran status, non-jobrelated disability/handicap or medical condition, family status, sexual orientation, religion, color, ethnicity, race or any other legally protected classification.