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Hybrid Specialist, Patient Transition Specialist, Patient Transition

Synapse Health · United States Of America · Hybrid

About the job

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

The Specialist, Patient Transition will report directly to the Supervisor, Member Transition. This role is an integral position within the Patient Transitions Department and will be the voice of the company as you interact with our patients, prescribers, payors and vendor network. You will ensure that orders are processed in an accurate, timely, compassionate and respectful manner. As a Specialist, Patient Transition, your primary responsibility is to process patient transitions to ensure accuracy of all orders, obtain and review qualifying documentation per payor guidelines, obtain any member financial payments, coordinate any vendor equipment transitions and ensure that the member experience is exceptional through best-in-class service. It is vital that you thrive in a fast-paced environment and embrace change as the company grows and evolves its systems and processes.

What You Will Do

  • Responsible for understanding insurance provider’s durable medical equipment (DME) guidelines, criteria for services, and authorization requirements.
  • Maintain excellent working knowledge of current products and services offered by the company.
  • Receive and process a high volume of patient/member DME transition files and orders, including but not limited to, order entry, verification of insurance eligibility, retrieving and reviewing all necessary documentation to validate qualification as required by patient/member’s insurance payor requirements, obtaining any needed authorizations from payors, patient payment collection, patient scheduling and coordination of care, prescriber and payor outreach, and processing of equipment returns, services, and exchanges.
  • Responsible for coordinating member transitions with partner vendors and communicating transition details with members, the identified member care team, and other internal department team members.
  • Provide status on previously submitted pre-authorizations or pre-determination requests.
  • Provide accurate information and updates to members, vendors, and providers as related to coordinated transitions, new orders, resupplies, pickups services, and exchanges.
  • Collaborate with vendors, prescribers, referral sources, and Synapse internal departments for assistance or education requests for members.
  • Demonstrate professionalism and provide high-quality service when interacting with patients, caregivers, and/or referrals.
  • Deliver a high-quality patient experience and meet the performance goals established for the position including productivity, call and email quality, member satisfaction, provider satisfaction, vendor satisfaction, and other Key Performance Indicators as established by Synapse leadership team.
  • Maintain confidentiality of patient/member health information and adhere to HIPAA guidelines.
  • Responsible for responding to patient/member concerns, inquiries, requests, or questions via telephone, email, chat, and within Synapse system platforms with a sense of urgency and advocacy to ensure member’s needs are met.
  • Demonstrated ability to listen skillfully, collect relevant information, and quickly assess the current state and formulate appropriate recommendations to resolve any escalated concerns.
  • Flexibility to customize approach to meet all types of communication styles and personalities.
  • Comply with all quality, compliance, provider, state, and any other regulatory requirements.
  • Represent the transition department on departmental and cross-functional projects related to improved customer experience, department efficiencies, and elevating the overall employee experience at Synapse Health.
  • Work with other department leaders on special tasks and/or projects.
  • Participate in an on-call rotation for after-hours member requests.
  • Perform other duties as required

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 of recent experience in durable medical equipment (DME) industry in the 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
  • Strategic Thinking: Demonstrates seeing the big picture, proactive planning, and putting thought into action.
  • Adaptability: Adapts quickly to change and easily considers new approaches.
  • Analytical Thinking: Demonstrates the ability to deconstruct information into smaller categories in order to draw conclusions.
  • Decision Making: Manages to make the right decision in complex situations.

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

Synapse Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

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