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Credentialing Coordinator
2 months ago
Company Background
LifeMD, a prominent player in the realm of virtual primary care, is based in New York City. We specialize in telehealth services, laboratory and pharmacy solutions, and targeted treatments for over 200 medical conditions, including primary care, men's health, women's health, allergy & asthma, and dermatology. Our proprietary digital care platform, coupled with a nationwide affiliated medical group and a dedicated patient care center, positions LifeMD at the forefront of accessible and affordable healthcare. Recently, we have experienced significant growth and recognition, ranking #166 in the 2023 Deloitte Fast 500.
Role Summary
The Credentialing Coordinator will report directly to the Director of Payor Enrollment, Licensing & Credentialing. This role is pivotal in managing all facets of medical licensing and credentialing processes, ensuring seamless operations in provider credentialing and payer contracts to enhance provider productivity.
Key Responsibilities
- Manage the credentialing and re-credentialing of LifeMD providers with insurance payors and hospitals, while maintaining the CAQH Provider System.
- Keep updated credentialing matrices for all LifeMD providers across various markets and states.
- Engage in regular follow-up communication with insurance payors regarding credentialing issues.
- Collaborate with other departments to facilitate the onboarding and offboarding processes for LifeMD providers.
- Assist providers with inquiries related to credentialing, licensing, or payor enrollment.
- Ensure that all necessary licensure and privileges are obtained for LifeMD providers.
- Create and maintain comprehensive provider credentialing rosters.
- Conduct thorough external research and verification of licensure, malpractice history, and educational credentials.
- Regularly check insurance payor websites for accurate directory listings and perform necessary updates.
- Meet organizational expectations for timely submission of payor applications.
- Handle complex administrative tasks, including drafting written correspondence and responding to routine inquiries.
- Maintain confidentiality and protect sensitive information related to providers and LifeMD operations.
- Work independently and collaboratively on special projects as assigned by the Director.
- Demonstrate reliability by consistently reporting to work on time and prepared for duties.
- Perform additional related tasks as required.
Qualifications
- Credentialing Certification and a Bachelor's Degree in Business Administration or Healthcare Administration, or equivalent experience.
- A minimum of 3 years of relevant experience in credentialing and administrative roles.
- Certifications such as Certified Provider Credentialing Specialist (CPCS) or Certified Medical Services Management (CPMSM) are preferred.
- Proficient knowledge of credentialing, licensing, and payor enrollment processes.
- Strong analytical skills with the ability to interpret complex data effectively.
- Familiarity with healthcare regulations and compliance standards is essential.
- Ability to adapt to new credentialing software and technologies.
- Exceptional communication skills, both written and verbal, with a strong capacity for conceptual presentation.
- Experience working in a fast-paced, dynamic environment.
- A creative problem solver and strategic thinker who excels in teamwork.
- Outstanding organizational and time management skills with meticulous attention to detail.
Employee Benefits
- Comprehensive Health Care Plan (Medical, Dental & Vision).
- Retirement Savings Plan (401k, IRA).
- Life Insurance Options (Basic, Voluntary & AD&D).
- Unlimited Paid Time Off.
- Paid Holidays.
- Short-Term & Long-Term Disability Coverage.
- Opportunities for Training & Development.
