Specialist, Qualifications

Synapse Health | Who We Are

With the collective efforts of our epic team members, we’re trailblazing a new path in the DME industry. Synapse Health was founded in 2016 with a goal to fix the fractured DME ecosystem and completely transform the industry. Built on decades of industry and leadership experience, we’ve launched tech-based solutions that eliminate age-old DME headaches, resulting in a seamless experience for all. We are proud to offer work that matters, on a mission that matters. 

Intrigued? Learn more at SynapseHealth.com and on Synapse Health’s LinkedIn.

What We Need

As a member of the Customer Connect Center (CCC), you will be the voice of the company as you interact with our customers. As a Qualifications Specialist, you will be responsible for reviewing, editing and maintaining all medical documentation. This role will perform audits to ensure the organization is adhering to guidelines and that orders are being processed in the most efficient and “clean” way as possible. This Specialist role will interact regularly with physician office staff and at times, the physicians themselves. Having the ability to quickly read/assess medical documentation is vital in this role. 

What You Will Do

• Manage referrals, including obtaining all required clinical information within established timelines.
• Responsible for recording all incoming orders in the medical record systems and handling the precertification and recertification process for Durable Medical Equipment (DME).
• Responsible for understanding insurance provider guidelines.
• Perform routine audits to ensure the accuracy of patient medical files and identify errors or issues by analyzing medical records and documents. 
• Responsible for coordinating medical record requests with referral sources and providers offices. Contact referral sources when additional documentation or clarification is required.
• Prepare and convert paper documentation into electronic copies to be stored in the organizations electronic document storage management system. 
• Maintain policies and procedures for documenting, storing & retrieving information and for processing medical & legal documents, insurance data & correspondence requests in conformance with federal, state and local statutes. 
•  Answers inquiries relating to information contained in patients' charts. 
• Understand health plan guidelines and authorize services accordingly.
• Run insurance cost estimate, collection of patient responsibility and, if applicable, explanation of rental/purchase options. 
• Present and explain provider of records documents and product education information to consumer, push out for signature,
• Develops educational materials and conducts instructional programs for health care personnel. 
• Work with a sense of advocacy and urgency to ensure that the patient’s/member’s, prescriber and referral source’s needs are being met.
• Deliver a high-quality patient experience and meet the performance goals established for the position including productivity, appropriate documentation received, call quality, member satisfaction, first call resolution and attendance.
• Maintain confidentiality of patient health information and adhere to HIPAA guidelines.
• Partner with the program leadership on escalated requests or questions.
• Participate in an on-call rotation for after-hours member requests. 
• Perform other job duties as assigned.

What You Have

At Synapse Health we’ve intentionally built a culture of kindness, collaboration and creativity, and we consider those qualities to be table stakes for any new team member. In addition, this role requires: 

• At least 2+ years' recent experience in the healthcare equipment or durable medical equipment (DME) industry in customer service & qualification department, DME logistics & transition role or any other related experience.
• Proficient in MS Office applications and ability to learn department and job-specific software systems.
• Demonstrate organizational skills.
• Demonstrate effective verbal and written communication skills.
• Demonstrate analytical skills when problem-solving.
• Demonstrate high attention to detail and a high degree of accuracy.
• Ability to work within the hours of 8am - 8pm EST with the potential for an on-call rotation.

 What Sets You Apart

• Customer Focus: Building strong customer relationships and delivering customer-centric solutions.
• Communicates Effectively: Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.
• Nimble Learning: Actively learning through experimentation when tackling new problems, using both successes and failures as learning fodder.
• Action Oriented: Taking on new opportunities and tough challenges with a sense of urgency, high energy and enthusiasm.
• Optimizes Work Processes: Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement.
• Tech Savvy: Comfortable navigating, learning and adopting new technologies .

What Sets Us Apart

It’s no secret that most of us work to provide for ourselves and those we love, but just because we have to work, doesn’t mean we can’t enjoy it. In fact, at Synapse Health, we insist on it! We want our team members to thrive personally and professionally, which is why our benefits include: 

• Professional growth opportunities with compelling career paths
• Healthy work-life balance culture with paid time off (PTO)
• Medical, dental and vision insurance for full-time team members
• 401K savings plan with employer contribution match

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