Therapy Access Specialist (Contractor) New United States - Remote

Cala Health, Inc.; Northern (KY); Hybrid; USD 30,000 - 47,000; Part time

Job summary

Cala Health, Inc. is seeking a Therapy Access Specialist to provide operational support to the Therapy Access organization. You will contact patients and healthcare providers for documentation, verify benefits, secure authorizations and handle referrals in a 1099 contractor role.

Remote position from the United States; you will use payor sites like Availity, NaviNet and Availity. This role requires strong communication, confidentiality, and meticulous data entry in CRM systems to ensure seamless

Qualifications

• 3 to 5 years of medical insurance experience, preferably at a medical company.
• Bachelor’s degree strongly preferred; high school diploma or equivalent required.
• Experience with insurance benefits and eligibility.
• Strong computer skills including CRM (Salesforce.com), payor sites such as NaviNet and Availity.
• Strong organizational skills and attention to detail.

Responsibilities

• Verify active health insurance coverage via phone with payor representatives.
• Use payor websites (Availity, NaviNet) to verify eligibility and submit prior authorizations.
• Communicate clearly in oral and written form; maintain confidentiality.
• Document interactions in CRM per QA, regulatory, and HIPAA guidelines.
• Collaborate with Sales Support to transfer benefit verification and authorization data.
• Data entry of new patient referrals into CRM.
• Contact new patient referrals for insurance confirmation.
• Provide telephone and department support as needed.
• Perform other related clerical duties as assigned.

Skills

Medical insurance experience

CRM (Salesforce)

Attention to detail

Strong communication

Confidentiality

Education

Bachelor's degree

High school diploma or equivalent

Tools

Salesforce.com

NaviNet

Availity

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 released Cala kIQ — 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 so much more. It’s all part of our mission to help people in their struggle with chronic disease. We’re only just getting started.

The Opportunity

The Therapy Access Specialist provides operational support to the Therapy Access organization including, but not limited to, contact patient and healthcare provider for documentation, verify insurance benefits, secure authorizations and other duties, as required. Other duties may include data entry of new patient referrals. This is a contractor (1099) position.

The Specialist requires specific knowledge of health insurance plans, interpretation of benefits and prior authorization protocol. Also, general knowledge of durable medical equipment (DME) coverage landscape is strongly recommended.

Location

Remote, must reside in the United States
Reports to: Associate Director, Therapy Access

Responsibilities

• Effectively and accurately verify active health insurance coverage via phone call with a payor representative.
• Effectively and accurately utilize the payor websites, such as Availity, NaviNet and others, to verify insurance eligibility and submit prior authorizations.
• Ability to communicate in a clear and effective manner, both orally and in writing.
• Ability to maintain confidentiality.
• Document all interactions and calls into the customer relationship management (CRM) system in accordance with Quality Assurance, Regulatory and HIPAA guidelines. Collaborate with Sales Support Representatives to transfer benefit verification and authorization data so the sale is completed accurately and efficiently.
• Data entry of new patient referrals into CRM
• Contact new patient referrals for insurance confirmation.
• Provide telephone and department support, as needed.
• Performs other related clerical duties, as assigned.

Skills and Experience

• 3 to 5 years of medical insurance experience, preferably at a medical company
• Bachelor’s degree is strongly preferred; High school diploma or equivalent required Experience in insurance benefits and eligibility
• Strong computer skills including CRM (Salesforce.com), payor sites, such NaviNet and Availity
• Strong organizational skills and attention to detail

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 , p erforming tasks such as data entry, document review, speaking on the phone, etc.

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.