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Credentialing Specialist
Credentialing SpecialistTryon Medical Partners • Charlotte, NC, US
Credentialing Specialist

Credentialing Specialist

Tryon Medical Partners • Charlotte, NC, US
23 hours ago
Job type
  • Full-time
  • Quick Apply
Job description

Credentialing Specialist   Description :

  • The Credentialing Specialist provides financial, administrative, and clerical support to Credentialing areas of Tryon Management Group.
  • This includes quarterly attestations and payer enrollment functions. (This is a full-time position based out of the MSO in SouthPark, Monday to Friday 8 am to 5 pm).

Responsibilities :

  • Monitors tasks within credentialing platform to mitigate any delays and ensure completion from internal stakeholders.
  • Actively reviews and resolves Enrollment dashboard issues within EMR system.
  • Alerts management to unfavorable patterns / trends.
  • Verify participation of all line of business with a payer.
  • Contact payer(s) on claims when an enrollment issue exists.
  • Acts as a point of contact for assigned department(s) for incoming questions regarding third-party billing requirements because of payer enrollment.
  • Analyzes trends in under / overpayments and payment denials and works collaboratively.
  • Keep provider enrollment tables up to date with effective participation / term dates, taxonomy codes, NPI within EHT platform.
  • Completes all internal On / Offboarding tasks for all clinicians.
  • Updates fee schedule in Practice Management system as needed.
  • Maintains allowable schedules in the Practice Management system, as needed.
  • Other duties as assigned.

    • Requirements :

  • Education and Certifications : High school diploma or GED required.
  • High level of proficiency in Microsoft Excel.
  • Ability to work autonomously and as a member of a team, team player with a positive attitude.

    • Experience :

  • 5+ years in a healthcare related industry All aspects of Payer Credentialing Front office operations Payer follow-up and collections Physical Requirements : Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
  • Must be able to lift and support weight of 35 pounds .
  • Ability to concentrate on details.
  • Use of computer for long periods of time.
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    Credentialing Specialist • Charlotte, NC, US