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 patients cost share responsibilities; communicate outcomes and collect payments
Secure document requirements for prior authorization; 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
Requirements
Bachelor’s degree is strongly preferred; High school diploma or equivalent required
Minimum of 5 years’ experience in a Customer Service or related type role
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
Demonstrate 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.com is preferred but not required
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
customer servicereimbursementrevenue cycle managementmedical documentationinsurance benefits investigationclinical record reviewprior authorizationsales order processingclaim submission preparationGood Manufacturing Practices
Soft skills
relationship buildingcollaborationproblem-solvingattention to detailprioritizationcommunicationdelegationteamworkadaptabilitycustomer interaction
Certifications
Bachelor's degreeHigh school diploma or equivalent