Credentialing Specialist

🕒 August 6

🇺🇸 United States – Remote

💵 $60k - $70k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🦅 H1B Visa Sponsor

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Logo of LifeMD

LifeMD

201 - 500 employees

🏥 Healthcare

💼 Consulting

📣 Marketing

Healthcare • Consulting • Marketing

LifeMD is a 50-state direct-to-patient telehealth company providing virtual primary care, diagnostics, and specialized treatments. They focus on men's and women's health, allergies, asthma, and dermatological issues. With a proprietary technology platform, a comprehensive medical group, and a nationwide mail-order pharmacy network, LifeMD aims to increase access to affordable healthcare. The company offers online consultations with board-certified doctors, covering various health concerns from weight management to chronic conditions, available anytime and anywhere.

📋 Description

• Credential and re-credential LifeMD providers with insurance payors and/or hospitals • Maintain and update insurance credentialing and the CAQH Provider System • Maintain credentialing matrices for all LifeMD providers and markets/states • Follow up regularly with insurance payors on credentialing matters • Collaborate with LifeMD departments to facilitate provider onboarding and offboarding • Assist providers with ancillary credentialing, licensing, and payor enrollment questions • Obtain necessary licensure and/or privileges for LifeMD providers • Create, maintain, and update provider credentialing rosters • Conduct external research and verify licensure, malpractice, educational degrees, diplomas, and certifications • Check insurance payor websites for accurate directory listings and perform regular updates • Meet expectations for consistent payor application submission • Perform complex and confidential administrative functions, including correspondence, memos, forms, and documents • Handle confidential and non-routine information while protecting provider and practice information • Work independently and with a team on special, ongoing, and nonrecurring projects requested by the Director of Payor Enrollment, Licensing & Credentialing • Update Excel spreadsheets or other systems and disseminate information • Report to work on time for scheduled hours and perform other related duties as required

🎯 Requirements

• Credentialing Certification • Bachelor’s Degree in Business Administration/Healthcare Administration or equivalent experience • 2+ years of relatable experience performing credentialing and administrative functions • Certified Provider Credentialing Specialist (CPCS), Certified Medical Services Management (CPMSM) or CPES (Certified Provider Enrollment Specialist) • Expertise in credentialing, multi-state licensing and multi-state payor enrollment functions and processes • Excellent analytical skills with the ability to interpret and act on complex data • Knowledge of healthcare regulations and compliance requirements • Proficiency and ability to adapt to new credentialing software • High level of proven communication skills, including written, verbal and conceptual presentation • Ability to work in a fast-paced, dynamic growth environment • Creative problem solver, strategic thinker and team player who thrives in a collaborative environment • Fantastic organizational and time management skills with high attention to detail

🏖️ Benefits

• Health Care Plan (Medical, Dental & Vision) • Retirement Plan (401k, Roth 401k) • Life Insurance (Basic, Voluntary & AD&D) • Flexible Paid Time Off • Paid Holidays • Short Term Disability • Training & Development

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