Therapy Access Specialist

Key skills

• Software Engineering
• Problem Solving
• System Design

Job description

About Cala

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.

Apply on the official Calahealth careers page

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