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Credentialing Coordinator
2 months ago
Company Background
LifeMD, a prominent provider of virtual primary care services, is based in New York City. The organization specializes in telemedicine, laboratory and pharmacy services, addressing over 200 medical conditions, including primary care, men's health, women's health, allergy & asthma, and dermatology. With a proprietary digital care platform and a network of affiliated medical professionals across all 50 states, LifeMD is dedicated to enhancing healthcare accessibility and affordability. The company has experienced significant growth and recognition in the industry.
Position Summary
The Credentialing Specialist will report directly to the Director of Payor Enrollment, Licensing & Credentialing. This role is essential in managing all facets of medical licensing and credentialing operations. The Credentialing Specialist will play a vital role in ensuring the smooth functioning of credentialing processes and payer contracts, ultimately contributing to provider efficiency.
Key Responsibilities
- Facilitate the credentialing and re-credentialing of LifeMD providers with insurance payors and hospitals. Maintain and update the CAQH Provider System and insurance credentialing records.
- Develop and manage credentialing matrices for all LifeMD providers across various markets and states.
- Engage in regular follow-up communications with insurance payors regarding credentialing issues.
- Collaborate with different departments within LifeMD to support the onboarding and offboarding processes for providers.
- Assist providers with inquiries related to credentialing, licensing, or payor enrollment.
- Secure necessary licenses and privileges for LifeMD providers.
- Create and maintain comprehensive provider credentialing rosters.
- Conduct thorough external research and verification of licensure, malpractice history, and educational qualifications for all LifeMD providers.
- Regularly check insurance payor websites to ensure accurate directory listings and perform necessary updates.
- Consistently meet LifeMD's expectations for timely payor application submissions.
- Execute complex administrative tasks, including drafting and typing correspondence, and responding to routine inquiries.
- Handle sensitive information with discretion, ensuring confidentiality of provider and company data.
- Work autonomously and collaboratively on special projects as directed by the Director of Payor Enrollment, Licensing & Credentialing, which may involve updating spreadsheets and disseminating information.
- 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.
- In-depth 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.
- Proficiency in adapting to new credentialing software and tools.
- Exceptional communication skills, both written and verbal, with the ability to present concepts clearly.
- Ability to thrive in a fast-paced, dynamic environment.
- Creative problem-solving skills and a collaborative mindset are crucial.
- Outstanding organizational abilities and 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
