Role Description Your north star: - Enroll clients referred to Pomelo’s doula network by health plans, providers, and doulas. This role reports to our Referral Specialist Manager and can be based anywhere in the continental US. What You'll Do: - Conduct outbound calls and digital outreach (SMS, email) to referred clients to drive new client enrollments, meeting quality and productivity requirements. - Document all incoming referrals and interactions in systems of record with timely and accurate updates. - Match clients with existing doulas in the Pomelo Care doula network. - Coordinate with health plan case managers and external healthcare providers to share updates on referrals and achieve enrollment goals. - Track, monitor, and enroll referrals, ensuring timely processing and communication with all parties. - Manage inbound calls from potential clients and external partners, answering their questions, addressing their concerns, and providing guidance on how Pomelo can support their needs. - Achieve member enrollment and doula matching goals as driven by company KPIs. - Maintain a high quality level for documentation and in interactions with clients and doulas. - Confirm client’s health plan eligibility details via automatic clearinghouse and online health insurance portals. - Participate in training and development opportunities to stay current on healthcare trends and regulations. Qualifications - Excellent customer service and communication skills. - Experience working with various healthcare referral systems. - Are internet-connected, able to work remotely. - Passionate about changing the current landscape of healthcare. - Strong organizational, documentation, and time-management skills. - Ability to work independently and as part of a team. 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). Compensation Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. Given that this role is open to candidates of different skill levels, determining a salary range is challenging. A reasonable estimate of the current salary range is $45,000 to $55,000, plus the opportunity to earn a performance bonus. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash. Potential Fraud Warning Please be cautious of potential recruitment fraud. With the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information. Pomelo Care will never ask you to pay a fee or download software as part of the interview process with our company. Pomelo Care will also never ask for your personal banking or other financial information until after you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All official communication with Pomelo Care People Operations team will come from domain email addresses ending in @pomelocare.com. If you receive a message that seems suspicious, we encourage you to pause communication and contact us directly at careers@pomelocare.com to confirm its legitimacy. For your safety, we also recommend applying only through our official Careers page. If you believe you have been the victim of a scam or identity theft, please contact your local law enforcement agency or another trusted authority for guidance.

Role Description We are seeking a highly motivated and detail-oriented Revenue Integrity Training Specialist to join our team. This dual-role position is crucial for maintaining the financial health of our regional operations by ensuring accurate charging, billing, and coding practices. The ideal candidate will possess a strong background in healthcare revenue cycle, auditing, documentation, training, and process improvement. The specialist will be responsible for conducting rigorous audits to identify and resolve payment discrepancies and denial trends, while simultaneously developing standard operating procedures (SOPs) and training new team members to uphold best practices across the region. - Research, develop and maintain concise written procedures and processes for internal RCM team(s), cross-functionally when needed. - Design training plans for new Privians, both within and outside of RCM Optimization. - Develop and document all workflow processes and procedures adhering to best practice standards. - Develop alternative training methods if expected improvements are achieved. - Complete monthly payer and fee schedule audits, charge alerts and downcoding in compliance with Privia policies, payer contracts and government fee schedules. - Ensure reimbursement by payer is accurate. - Make independent decisions regarding audit results, communicate with appropriate teams to ensure optimal revenue opportunity. - Identify, monitor and inform the RCM team of denial trends creating revenue delays and leakages. - Assist with Trizetto/Cognizant setup, fee schedule setup. - Work and address Salesforce cases in a timely manner. - Address requests for Care Center payment performance audits to assist in maximizing cash flow, as well as tracking and reporting the outcomes of both scheduled payer audits and requested Care Center audits. - Evaluate training progress and competency by conducting routine quality audits, providing meaningful feedback to RCM leadership. - Coordinate all aspects of training activities. - Special projects and other duties as assigned, focused on key performance and department goals. Qualifications - 3+ years of experience in a medical billing office preferred. - 3+ years of experience with payer contracts (language) and/or auditing payer payments. - Experience working in Trizetto EOB resolve a plus. - AthenaOne software system experience is a plus. - Experience with multiple RCM functions, including a thorough understanding of revenue integrity processes and impact is a plus. - Experience with Google Suite: Sheets, slides, forms preferred. - Must be highly analytical, identify payment variance due to contract build or process errors, resolve. - Knowledge of principles and methods for process documentation, curriculum and training design with the ability to research and review processes. - Highly organized and able to manage multiple priorities effectively. - A collaborative and positive team player with a desire to cultivate a culture of unconditional positive regard. - Skilled in documenting clearly defined processes, standard operating procedures, and policies. - Intermediate Excel Knowledge (basic formulas, pivot tables). - Strong critical thinking and problem solving skills. - Must comply with HIPAA rules and regulations. Requirements - The salary range for this role is $60,000.00-$65,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). - This role is also eligible for an annual bonus targeted at 10%. - The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Benefits - All your information will be kept confidential according to EEO guidelines. - Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Role Description The TMF Specialist serves as a subject matter expert (SME) for Trial Master File management across clinical programs. This role ensures the TMF is complete, accurate, and inspection ready at all times, while driving quality standards, process improvements, and where vendor oversight applicable. The TMF Specialist partners closely with Clinical Operations, Quality, Regulatory, and CRO teams to ensure documentation excellence throughout the study lifecycle. The TMF Specialist reports to a Director in Clinical Operations or a TMF Lead. Qualifications - Bachelor’s degree in life sciences, healthcare, or related field (or equivalent experience). - Typically 3–5+ years of experience in clinical research with direct TMF ownership or oversight. - Strong working knowledge of ICH GCP, TMF Reference Model, and regulatory documentation requirements. - Experience collaborating with or overseeing CROs. Requirements - Deep understanding of TMF structure, essential documents, and clinical trial lifecycle. - Strong analytical skills with the ability to identify trends, risks, and quality gaps. - High attention to detail and commitment to documentation accuracy. - Proficiency with eTMF systems (e.g., Veeva Vault, Wingspan, Trial Interactive). - Excellent communication, stakeholder management, and problem solving skills. - Ability to work independently and lead TMF-related initiatives. Benefits - Experience supporting regulatory inspections (FDA, EMA, MHRA). - Familiarity with risk-based TMF management approaches. - Experience with multiple therapeutic areas or global studies. - Prior involvement in SOP development or process optimization.

• Submit and manage USA insurance claims accurately and timeously. • Follow up on unpaid, denied, or rejected claims. • Work with insurance remits/EOBs and payment postings. • Investigate and resolve billing discrepancies. • Communicate with insurance companies regarding claims and denials. • Maintain accurate billing records and documentation. • Ensure payer requirements and authorisation guidelines are followed. • Work across multiple insurance portals and systems. • Escalate unresolved billing issues where necessary. • Assist with revenue cycle and claims management processes.