Therapy Access Specialist (Contractor)

Cala Health

21d•Remote

About The Position

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.

Requirements

3 to 5 years of medical insurance experience, preferably at a medical company
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
Strong customer service skills
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.

Nice To Haves

Bachelor’s degree is strongly preferred
general knowledge of durable medical equipment (DME) coverage landscape is strongly recommended

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.