What are the responsibilities and job description for the Credentialing Specialist position at Tryon Medical Partners?
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 with the ability to work remotely but preferably based in Charlotte NC. The expectation is to be available during regular business hours. Monday to Friday 8 am to 5 pm EST)
Responsibilities:
Education and Certifications:
(This is a full-time position with the ability to work remotely but preferably based in Charlotte NC. The expectation is to be available during regular business hours. Monday to Friday 8 am to 5 pm EST)
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
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
- 5 years in a healthcare related industry
- All aspects of Payer Credentialing
- Front office operations
- Payer follow-up and collections
- 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