Apply on Employer Site

Pomelo Care · 1 day ago

Provider Credentialing Specialist

United States

Full-time

Remote

Entry, Mid Level

$55K/yr - $75K/yr

2+ years exp

Pomelo Care is the national leader in evidence-based healthcare for women and children. They are seeking a Provider Credentialing Specialist to work with the New Ventures team to complete health plan credentialing accurately and efficiently, ensuring proper clinician licensure and facilitating the credentialing process.

ChildrenHealth CareMobile AppsWomen's

Responsibilities

Complete group & practitioner health plan credentialing on behalf of Pomelo’s telehealth clinic & care team

Track applications from submission to approval, contracting, and agreement, ensuring cross-functional visibility into key milestones & timelines

Proactively mitigate application delays & denials; Rigorously follow up on any delays and/or denials to right-size

Follow up on any delays and/or denials; Proactively update workflows to Rigorously follow up with Proactively mitigate application delays & denials; Rigorously follow up on delays & denials

Collaborate with Pomelo licensing, credentialing, and enrollment team to ensure proper clinician licensure & up-to-date CAQH profiles, to help expedite health plan credentialing

Collaborates with care team of nurses, nurse practitioners, doctors, therapists & registered dietitians to support navigation & answer questions about clinician credentialing applications

Qualification

Health plan credentialingCAQH profilesCommercial health plansCredentialing processesAttention to detailProblem-solvingTeam collaborationCommunication skillsTime management

Required

2-4 years of experience in a high volume, credentialing specialist role

Deep expertise with commercial health plan credentialing processes, including health plan portals & CAQH

Highly organized with a strong attention to detail

A proactive and resourceful problem-solver who is comfortable navigating ambiguity and independently seeks out answers and solutions

An accountable and collaborative team player with excellent communication skills, both written and verbal

An expert at prioritization & time management, who proactively shares deliverable timelines and roadblocks

Benefits

Competitive healthcare benefits

Generous equity compensation

Unlimited vacation

Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)