Credentialing Coordinator
Imagine PediatricsSalary not specified
Full Time
Junior (1 to 2 years)
Not SpecifiedCompensation
Entry Level & New Grad, Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Telehealth, Women's HealthIndustries
Requirements
- 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
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
- Collaborate with Pomelo licensing, credentialing, and enrollment team to ensure proper clinician licensure & up-to-date CAQH profiles, to help expedite health plan credentialing
- Collaborate with care team of nurses, nurse practitioners, doctors, therapists & registered dietitians to support navigation & answer questions about clinician credentialing applications
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What experience is required for the Provider Credentialing Specialist role?
Candidates need 2-4 years of experience in a high volume credentialing specialist role and deep expertise with commercial health plan credentialing processes, including health plan portals and CAQH.
What are the main responsibilities of this position?
The role involves completing group and practitioner health plan credentialing, tracking applications from submission to approval, proactively mitigating delays and denials, and collaborating with licensing, credentialing, enrollment, and care teams.
What is the salary for the Provider Credentialing Specialist position?
This information is not specified in the job description.
Is this a remote position?
This information is not specified in the job description.
What kind of company culture does Pomelo Care have?
Pomelo Care is a multi-disciplinary team of clinicians, engineers, and problem solvers passionate about improving care for moms, babies, and women through evidence-based, technology-driven virtual care.
Pomelo Care
Personalized healthcare for pregnancy and newborns
About Pomelo Care
Pomelo Care provides personalized healthcare services for pregnant individuals and newborns. The company combines traditional medical practices with advanced technology to improve health outcomes for families. Their services are designed to be accessible and focus on evidence-based care, ensuring that expectant mothers and their newborns receive the best possible support. Unlike many competitors, Pomelo Care emphasizes a tailored approach to healthcare, integrating technology to enhance the patient experience. The goal of Pomelo Care is to create a supportive environment that promotes the health and well-being of families during pregnancy and early childhood.
New York City, New YorkHeadquarters
2021Year Founded
$84.6MTotal Funding
SERIES_BCompany Stage
HealthcareIndustries
11-50Employees
Benefits
Health Insurance
Company Equity
Paid Vacation
Risks
Competition from similar maternity care providers may reduce Pomelo's market share.
Operational challenges from integrating The Doula Network could affect service delivery.
Regulatory scrutiny on virtual healthcare may increase compliance costs for Pomelo.
Differentiation
Pomelo Care combines virtual and in-person maternity services, unique in the industry.
The acquisition of The Doula Network enhances Pomelo's comprehensive care model.
Pomelo uses data science to improve maternal and infant health outcomes.
Upsides
Increased demand for telehealth boosts Pomelo's virtual care services.
Expansion of Medicaid coverage offers Pomelo new market opportunities.
Growing interest in personalized healthcare aligns with Pomelo's service model.
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