Specialist, Qualifications- Brentwood, TN

Who We Are:

At Synapse Health, we’re streamlining the durable medical equipment (DME) process.

We manage intake, documentation, routing, claims, billing, and patient support. Our model reshapes how DME is delivered and experienced.

Since
2016,with decades of industry and leadership experience,we’vedelivered tech-based solutions that help our partners to modernize operations, improve coordination, and reduce administrative burdens. By taking on operational and financial complexity,we’reredefining how DME works for providers, prescribers, and patients.

We are proud to offer work that matters, on a mission that matters
.

Learn more at  and on Synapse Health’s Linked In.

As a Specialist, Qualifications within the Customer Connect Center (CCC) at Synapse Health, you serve as a critical gatekeeper of clinical accuracy, documentation quality, and regulatory compliance. You are responsible for reviewing, validating, and maintaining medical documentation to ensure orders meet payer, clinical, and operational requirements before fulfillment.

In this role, you regularly interact with physician offices and, at times, prescribing providers to obtain, clarify, and validate clinical information. Your ability to efficiently interpret medical records, apply insurance and payer guidelines, and identify documentation gaps is essential to ensuring clean, timely, and compliant DME order processing.

This position is fully onsite in the Synapse Health office in Brentwood, TN (37027).

• Manage incoming referrals, ensuring all required clinical and supporting documentation is obtained within established timelines.
• Review, record, and maintain all incoming orders and documentation within electronic medical records and document management systems.
• Coordinate and process precertification and recertification requirements for Durable Medical Equipment (DME).
• Apply payer and insurance provider guidelines to determine documentation requirements and authorization eligibility.
• Perform routine audits of patient medical files to ensure accuracy, completeness, and compliance with internal standards and regulatory requirements.
• Identify documentation discrepancies, errors, or missing information and work directly with referral sources and provider offices to obtain clarification or corrections.
• Prepare, convert, and maintain paper and electronic documentation in accordance with organizational document storage and retention policies.
• Maintain compliance with policies and procedures related to documenting, storing, and retrieving medical, legal, and insurance information in accordance with federal, state, and local regulations.
• Respond to inquiries related to patient charts, documentation status, and qualification requirements.
• Run insurance cost estimates, collect patient responsibility information, and explain rental versus purchase options when applicable.
• Present and distribute provider documentation and product education materials to patients, coordinating electronic signature collection as required.
• Support educational efforts by contributing to instructional materials and assisting with training for healthcare personnel, as needed.
• Act with advocacy and urgency to ensure the needs of patients, prescribers, and referral sources are met efficiently.
• Deliver a high-quality patient experience while meeting established performance metrics, including productivity, documentation accuracy, call quality, member satisfaction, first call resolution, and attendance.
• Maintain strict confidentiality of patient health information and adhere to HIPAA and organizational privacy standards.
• Partner with program leadership and senior team members on escalated cases or complex qualification questions.
• Participate in an on-call…