Member Transitions Specialist

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've delivered tech-based solutions that help our partners to modernize operations, improve coordination, and reduce administrative burdens. By taking on operational and financial complexity, we're redefining how DME works for providers, prescribers, and patients. We are proud to offer work that matters, on a mission that matter s . Learn more at SynapseHealth.com and on Synapse Health’s LinkedIn . What We Need : The Specialist, Member Transitions reports directly to the Manager, Member Transitions and plays a vital role within the Patient Transitions Department. In this role, you serve as the voice of Synapse Health for patients, prescribers, payors, and vendor partners throughout complex transition events. You ensure transitions are executed accurately, efficiently, and compassionately while delivering an exceptional member experience. As a Specialist, Member Transitions, you are responsible for managing end-to-end transition workflows, including order accuracy, qualification and documentation review, authorization coordination, patient financial responsibility , and vendor equipment transitions. You thrive in a fast-paced, high-volume environment and embrace change as systems, processes, and programs evolve to support organizational growth. What You Will Do : Maintain a strong working knowledge of insurance provider DME guidelines, coverage criteria, and authorization requirements. Maintain familiarity with Synapse Health products, services, and transition workflows. Manage a high volume of patient/member transition files and DME orders, including: Order entry and validation Insurance eligibility verification Retrieval and review of qualifying clinical documentation per payor guidelines Authorization and pre-determination coordination Patient financial responsibility collection Scheduling, care coordination, and prescriber/payor outreach Processing equipment returns, exchanges, and service transitions Coordinate member transitions with partner vendors and communicate transition details with members, care teams, and internal departments. <span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335559685":0,"335559737":0