Credentialing Specialist

LifeMD

6d•$60,000 - $70,000

About The Position

LifeMD is a leading provider of virtual primary care, telehealth, and specialized treatment programs serving hundreds of thousands of patients nationwide. Our vertically integrated platform combines 50-state licensed providers, in-house pharmacy and lab integrations, and proprietary technology that enables safe, high-quality, and affordable care. At the heart of this transformation is our team of developers, engineers, and tech innovators building state-of-the-art systems that make healthcare smarter, faster, and more accessible. From architecting scalable backend systems to crafting intuitive user experiences, we are pushing boundaries every day. Recognized as one of the fastest-growing healthcare tech companies (#166 on Deloitte Fast 500 in 2023), LifeMD is not just a healthcare company — it's a tech company revolutionizing healthcare. The Credentialing Specialist reports to the Director of Payor Enrollment, Licensing & Credentialing and is responsible for supporting all aspects of the medical licensing and credentialing processes. The Credentialing Specialist will ensure the efficient operation of medical licensing, credentialing, and payer contracts to maximize provider efficiency.

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
Key to have 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

Responsibilities

Credential/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
Provide follow-up correspondence with insurance payors on a regular basis for all credentialing matters
Work with other LifeMD departments to facilitate the onboarding/offboarding of LifeMD providers
Assist LifeMD providers with any ancillary credentialing, licensing or payor enrollment questions
Obtain necessary licensure and/or privileges for LifeMD providers
Create, maintain and update provider credentialing rosters for LifeMD
Performs external research and conducts verification of all LifeMD licensure, malpractice and educational degrees, diplomas and certifications
Checks insurance payor websites for accurate directory listings and performs regular updates
Meet LifeMD expectations for payor application submission on a consistent basis
Performs complex and confidential administrative functions including developing and typing written correspondence. Responds to routine external correspondence. Types memos, and other department forms and documents
Handles confidential and non-routine information and maintains provider confidence and protects operations by keeping all provider and LifeMD practice information confidential
Work independently and within a team on special and nonrecurring and ongoing projects at the request of the Director of Payor Enrollment, Licensing & Credentialing, which may include updating Excel spreadsheets or other systems, and disseminating information
Reliability- it is an essential function of this position to report to work on time for your scheduled hours, ready for work
Perform other related duties as required