Cala Health - Therapy Access Specialist (Contractor)
Requirements
• 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 • Strong customer service skills • Physical Demands • 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, performing 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.
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 • Provide telephone and department support, as needed. • Performs other related clerical duties, as assigned.
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