About The Role:

Your north star: Support the Pomelo clinical practice by owning key insurance, benefits, and administrative processes.

This role reports to the Senior Manager of Midlife Operations and can be based anywhere in the continental US.

What You'll Do:

• Verify insurance coverage / eligibility for our doula & midlife lines of business
• Initiate, track, and obtain provider referrals & prior authorizations
• Support cost estimation workflows, including use of payer portals & member support lines to verify level of coverage
• Interact directly with patients, providers, and patients via phone, chat, portal, and SMS
• Monitor our member support email & phone line
• Maintain and manage spreadsheets to support key operational workflows
• Collaborate with Midlife & Doula Operations to develop new workflows focused on improving care coordinator efficiency
• Other responsibilities as assigned
• Schedule: Day Shift - Monday - Friday, 9:00am - 6:00pm ET

Who You Are:

• 3+ years healthcare administration experience, ideally having worked within virtual care
• Familiar with insurance verification, in-network referrals, and Rx / Lab orders
• Ability to navigate benefits & insurance questions for Medicaid & Commercial members
• Comfortable interacting directly with patients, providers, and patients via phone, chat, portal, and SMS
• Results-oriented operator who moves fast
• Meticulous attention to detail
• Goes the extra mile for patients
• Comfort with ambiguity
• Ability to work cross-functionally with clinicians
• Passionate about women’s health

Why you should join our team

By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup that always puts the patient first. You will learn, grow and be challenged, and have fun with your team while doing it.

We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first.

Benefits and Perks:

• Comprehensive Health, Dental, and Vision coverage for employees and their families
• High deductible Health Plans with Health Savings Account (HSA) options
• Flexible Spending Account (FSA)
• Equity grant participation
• 401(k) program
• Competitive vacation policy
• 16 weeks paid parental leave
• Fully remote work flexibility (within the US)

Compensation

The expected base salary range offered for this role is $55,000-$65,000. This role is also eligible for equity, giving you an ownership stake in Pomelo’s mission. Actual compensation may vary based on relevant experience, skills, competencies, and certifications.

At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.

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