Synapse Health · 14 hours ago
Specialist, Qualifications
United States
Full-time
Remote
Entry Level
2+ years exp
Maximize your interview chancesHospital & Health Care
Hiring Manager
Madeline Sevigny
Insider Connection @Synapse Health
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Responsibilities
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.
Qualification
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Required
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.
Benefits
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
Company
Synapse Health
Synapse Health is on a mission to transform the DME industry with innovative solutions that improve experience, accountability and transparency for all.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Anthony Kilgore
Chief Executive Officer
Andrew Hayek
Co-Founder & Chairman
Company data provided by crunchbase
