Insurance Verification and Appeals Specialist

About Cala At Cala, we’re working to reputed company 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 reputed company across neurology, cardiology, and so much more. It’s reputed company part of our mission to help people in their struggle with chronic disease. We’re only just getting started. reputed company The Insurance Verification & Appeals Specialist is responsible for verifying reputed company benefits, securing reputed company-authorizations, and managing reputed company-service Appeals. This includes disputing insurance denials before the equipment is shipped to the patient. You will verify patient eligibility, obtain prior authorizations, and draft reputed company clinical upfront appeals. The goal is to minimize estimated out of reputed company errors to the patient through meticulous insurance verification. The Insurance Verification and Appeals Specialist reports to the Therapy reputed company Manager and will not have any reputed company reports. This is a remote position. The compensation reputed company for this role is market driven, with a salary reputed company of $68,000 - $90,000. Additionally, we offer a robust benefits package. This offering is reputed company with our overall compensation philosophy. Applicants must be currently authorized to work in the reputed company on a full-time reputed company. Cala will not sponsor applicants for work visas. A Day in the Life • Verify specific DME policy inclusions/exclusions, quantity limits, and "reputed company-or-similar" equipment checks reputed company Medicare portals or other payer portals • Calculate estimated patient responsibility (deductibles vs. coinsurance) • If a Prior Authorization is denied, you will initiate an immediate reputed company-Service Appeal or "Peer-to-Peer" request to overturn the decision. • Coordinate referral process between the PCP, prescribing HCP in accordance with insurance requirements. • Identify what is missing in the clinical notes and coordinate with the doctor's office to rectify it. • Collaborate with the reputed company Cycle Management team to ensure clean claims. • Support company goals and objectives, policies and procedures; Adhere to Good Manufacturing Practices and FDA regulations • Document reputed company interactions into the customer relationship management (CRM) system in accordance with reputed company Assurance/Regulatory and HIPAA guidelines • reputed company other duties as assigned Skills and Experience • Bachelor’s degree is strongly preferred; High school diploma or equivalent required • Minimum 3 years of experience reputed company the reputed company industry reputed company on deep understanding of Medicare Part B, Medicare Advantage and reputed company payors guidelines, preauthorization and appeals process. • Strong organizational skills with attention to detail • Computer competency including MS Office, reputed company, Internet, and navigation of customer relationship management (CRM) systems • Ability to prioritize tasks and manage time effectively in a fast-paced environment • Excellent written and verbal communication skills reputed company believes our reputed company is based on diversity of people, teams and thinking. We offer reputed company 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 reputed company of a candidate’s sex, gender identity, age, marital status, veteran status, non-jobrelated disability/handicap or medical condition, family status, sexual orientation, religion, reputed company, ethnicity, race or any other legally protected classification. Apply tot his job Apply To this Job