Revenue Cycle Specialist

Pomelo Care

6h • $55,000 - $65,000

About The Position

At Pomelo Care, we are redefining the healthcare journey for women and children. As the leading virtual medical practice in our field, we provide a continuous circle of support—from the first steps of family building and the complexities of pregnancy to the nuances of postpartum, pediatric, and midlife care. We aren't just a clinic; we are a multidisciplinary engine of clinicians, engineers, and problem-solvers dedicated to closing the gaps in traditional care. By leveraging a high-touch, technology-driven platform, we identify risks early and deliver deeply personalized, 24/7 virtual care. We are here to prove that better data and patient-centered care lead to better outcomes, raising the standard of care for families nationwide.
Your north star: In this role, you will be accountable for the accurate and timely submission and reconciliation of claims for the Pomelo medical practice including:

Requirements

• 3+ years experience in revenue cycle support role
• Proficiency in using medical billing software and EHR systems
• Proficient in Microsoft Excel and/or Google Sheets
• Independent, critical thinker with meticulous attention to detail
• Demonstrate proficiency in navigating multiple systems and workflows while maintaining adaptability in a rapidly changing environment

Responsibilities

• Reviewing and submitting claims within payor guidelines to ensure timely and accurate filing
• Reporting on aging encounters, and partnering with clinicians to resolve them, ensuring compliance with internal best practices
• Resolving and appealing claims denials, and working with the Revenue Cycle Manager to improve workflows and optimize our claim submission process
• Reconciling ERAs by resolving holds, manually posting payments and adjudicating claims
• Collaborating with other teams to identify and update missing patient demographic and insurance data
• Proactively identifying opportunities and implementing processes to optimize efficiency and accuracy within the billing function
• Collaborating effectively within a team-oriented environment and demonstrating a proactive approach to managing small projects across various functions

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed