Referral Specialist

Fluent in Spanish Excellent customer service and communication skills. Experience working with various healthcare referral systems. Are internet-connected, able to work remotely. Familiar with working with people assigned to Medicaid health plans. 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.

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 goals as driven by company KPIs. 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.