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Credentialing Specialist
LifeMD New York, NY
Apply
$52k-65k (estimate)
Full Time 2 Days Ago
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LifeMD is Hiring a Credentialing Specialist Near New York, NY

Job Description

Job Description

About us

LifeMD is headquartered in NYC and is a leading provider of virtual primary care. LifeMD offers telemedicine, laboratory and pharmacy services, and specialized treatment across more than 200 conditions, including primary care, men’s health, women’s health, allergy & asthma, and dermatology. Leveraging a vertically-integrated, proprietary digital care platform, a 50-state affiliated medical group, and a US-based patient care center, LifeMD is elevating healthcare by increasing access to top-notch and affordable care. LifeMD is currently in the midst of immense growth and was recently ranked #166 in the 2023 Deloitte Fast 500.

About the role

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.

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

Requirements

  • Credentialing Certification, Bachelor’s Degree in Business Administration/Healthcare Administration or equivalent experience
  • 3 years of relatable experience performing credentialing and administrative functions
  • Certified Provider Credentialing Specialist (CPCS), Certified Medical Services Management (CPMSM)
  • Expertise in credentialing, licensing and 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 a high attention to detail

Benefits

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

Job Summary

JOB TYPE

Full Time

SALARY

$52k-65k (estimate)

POST DATE

09/15/2024

EXPIRATION DATE

09/30/2024

WEBSITE

lifemd.com

HEADQUARTERS

FRANKLIN D ROOSEVELT, NY

SIZE

25 - 50

FOUNDED

2016

CEO

JUSTIN SCHREIBER

REVENUE

$10M - $50M

INDUSTRY

Ambulatory Healthcare Services

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The following is the career advancement route for Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist. You can explore the career advancement for a Credentialing Specialist below and select your interested title to get hiring information.

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If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Credentialing Specialist job description and responsibilities

A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.

03/14/2022: Des Moines, IA

A credentialing specialist can have certificates that will prove useful to their field.

02/01/2022: Newark, NJ

Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.

02/21/2022: Evansville, IN

Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.

02/01/2022: Las Cruces, NM

Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.

01/18/2022: Pueblo, CO

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Credentialing Specialist jobs

Credentialing specialists can often find work with a high school diploma or the equivalent.

01/25/2022: Kingsport, TN

Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.

03/01/2022: Parkersburg, WV

While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.

12/25/2021: Little Rock, AR

Make Use Of Advanced Software For Monitoring.

01/18/2022: New London, CT

Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.

01/31/2022: Portsmouth, OH

Step 3: View the best colleges and universities for Credentialing Specialist.

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