Credentialing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Credential and re-credential LifeMD providers with insurance payors and/or hospitals.

• Maintain and update insurance credentialing along with the CAQH Provider System.

• Keep credentialing matrices up-to-date for all LifeMD providers across various markets and states.

• Regularly follow up with insurance payors regarding credentialing issues.

• Collaborate with different LifeMD departments to streamline the onboarding and offboarding processes for providers.

• Assist providers with queries related to ancillary credentialing, licensing, and payor enrollment.

• Acquire necessary licensure and/or privileges for LifeMD providers.

• Create, maintain, and update rosters for provider credentialing.

• Conduct external research and validate LifeMD licensure, malpractice records, educational degrees, diplomas, and certifications.

• Verify accurate directory listings on insurance payor websites and perform regular updates.

• Meet expectations for timely submission of payor applications.

• Execute complex and confidential administrative tasks, including written correspondence, memos, forms, and documents.

• Manage confidential and non-standard information while safeguarding provider and practice details.

• Work both independently and collaboratively on special, ongoing, and nonrecurring projects as requested by the Director of Payor Enrollment, Licensing & Credentialing.

• Update Excel spreadsheets or other systems and disseminate relevant information.

• Report to scheduled work promptly and prepared to begin tasks.

• Perform additional related duties as assigned.

⛳️ Requirements

• Credentialing Certification, Bachelor's Degree in Business Administration/Healthcare Administration, or equivalent experience.

• Over 2 years of relevant experience in credentialing and administrative roles.

• Certification as a Provider Credentialing Specialist (CPCS), Certified Medical Services Management (CPMSM), or Certified Provider Enrollment Specialist (CPES).

• Proficiency in credentialing, multistate licensing, and multistate payor enrollment functions and processes.

• Strong analytical capabilities with an aptitude for interpreting and acting on complex data.

• Familiarity with healthcare regulations and compliance requirements.

• Competence in adapting to new credentialing software.

• Demonstrated written, verbal, and conceptual presentation communication skills.

• Ability to thrive in a fast-paced, dynamic growth setting.

• Creative problem-solving and strategic thinking skills.

• Ability to function effectively as a collaborative team member.

• Excellent organizational and time-management skills with a keen attention to detail.

🏝️ Benefits

• Compensation: $60,000-$70,000 annually.

• 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.