Credentialing Specialist

Credentialing Specialist

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 South Park, Monday to Friday 8 am to 5 pm.

• 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/over payments 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.

• 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.