Credentialing Specialist

Job Summary

To support the efficient operation of medical licensing and credentialing processes, the full-time remote Credentialing Specialist will manage the credentialing of providers with insurance payors and hospitals, maintain credentialing matrices, and facilitate onboarding and offboarding procedures.

Key responsibilities

• Credential and re-credential LifeMD providers with insurance payors and maintain the CAQH Provider System
• Provide follow-up correspondence with insurance payors regarding credentialing matters and ensure accurate directory listings
• Conduct external research and verification of licensure, malpractice, and educational credentials for LifeMD providers

Required qualifications

• Credentialing Certification and a Bachelor's Degree in Business Administration/Healthcare Administration or equivalent experience
• 2+ years of relevant experience in credentialing and administrative functions
• Certification as a Provider Credentialing Specialist (CPCS) or Certified Medical Services Management (CPMSM)
• Expertise in multi-state licensing and payor enrollment processes
• Knowledge of healthcare regulations and compliance requirements