Credentialing and Contracting Coordinator

Job Title: RCM Credentialing & Contracting Coordinator

Department: Revenue Cycle Management (RCM)

Reports To: Director of Revenue Cycle Management

Location: Remote

Overview

Nira Medical is a national partnership of physician-led, patient-centered independent practices committed to driving the future of neurological care. Nira's mission is to enable clinicians to provide access to life-changing treatments so you can provide the best possible patient outcomes. Founded by neurologists who understand the unique challenges of the field, Nira Medical supports practices with cutting-edge technology, clinical research opportunities, and a collaborative and comprehensive care network dedicated to advancing the standard of care. As we enter the next phase of growth, our focus is on scaling our teams, services, and elevating the customer experience!

This is where you come in…

The Credentialing & Contracting Coordinator plays a critical role in ensuring Nira Medical’s providers, locations, and services are fully credentialed, contracted, and revenue-ready across all payers. This role manages provider enrollment, contract updates, and payer-related operational tasks needed to support new hires, new locations, acquisitions, and organizational expansion. The Coordinator ensures timely provider enrollment, contract execution, and adherence to payer requirements while proactively resolving credentialing- or contracting-related issues that may impact revenue. This position requires a hands-on, process-driven mindset with the ability to problem-solve, build scalable workflows, and collaborate effectively with providers, payers, and internal teams. As part of a growing RCM structure, the role is ideal for someone who thrives in a fast paced environment and can help strengthen Nira’s credentialing and contracting foundation with structure, accuracy, and operational discipline. The Coordinator partners cross functionally with RCM, Operations, Billing, Corporate Development, and external payer partners to ensure compliance and support the organization’s evolving revenue cycle needs.

Here’s what you’ll be doing…

Provider Credentialing & Enrollment: This role ensures all providers are fully credentialed and enrolled in accordance with state, federal, and payer-specific regulations. Responsibilities include maintaining an accurate credentialing database, tracking expirations and renewals, and managing complete enrollment workflows with Medicare, Medicaid, and commercial payers. The Coordinator oversees CAQH maintenance, NPI and PECOS updates, and payer portal applications while monitoring enrollment timelines and following up with payers to prevent delays. All supporting documentation is kept current, organized, and accessible to internal teams who rely on enrollment status for revenue readiness.

Payer Contracting & Rate Management: The position supports the management and optimization of payer contracts by monitoring renewal timelines, ensuring appropriate reimbursement rates, and assisting in contract analysis. The Coordinator helps verify rate accuracy, process contract load requests, and evaluate payer participation needs for new locations, acquisitions, and service expansions. This role collaborates with Corporate Development and RCM leadership to ensure fee schedules, payer mappings, and reimbursement structures are set up correctly and aligned with organizational strategy.

Compliance & Regulatory Oversight: The Coordinator ensures compliance with all payer credentialing requirements and regulatory standards while maintaining clean, audit-ready credentialing files. This includes preparing reports for leadership, supporting internal and external audits, and keeping a centralized tracking system with real-time updates on application status. The role ensures that documentation, payer correspondence, and operational updates are consistently accurate, organized, and compliant.

Provider & Payer Relationship Management: This role serves as a key liaison between providers, payers, and internal revenue cycle teams, facilitating timely issue resolution and clear communication. The coordinator provides education to providers regarding reimbursement structures, contract terms, and credentialing expectations, ensuring that both clinical and operational stakeholders understand the impact of payer requirements on revenue and compliance.

Revenue Cycle & Operational Collaboration: The Coordinator partners closely with RCM teams to ensure provider enrollment and credentialing processes do not disrupt cash flow or claim submission readiness. This includes identifying and resolving credentialing-related payment issues, supporting onboarding for new providers and practice locations, coordinating payer setup requirements with IT and EMR teams, and escalating enrollment risks when needed. The role plays a critical part in ensuring operational continuity and financial performance during provider or location transitions.

Location, Address, and Operational Updates: This role manages all facility-level and operational changes that must be communicated to payers, including address updates, NPI/TIN linkages, Pay-To and Billing address changes, and the addition of new locations to existing contracts. The coordinator submits required documentation, tracks payer acknowledgments or approvals, and ensures updates are fully processed to prevent revenue disruption.

Here’s what we’re looking for…

• Associate’s/bachelor’s degree in healthcare administration, business, or a related field; or equivalent relevant experience in credentialing, payer contracting, or healthcare operations

• Minimum 4+ years of experience in provider credentialing, payer enrollment, or payer contracting

• Strong knowledge of payer credentialing requirements, fee schedules, and contract structures

• Minimum 3+ years of experience in revenue cycle management, healthcare regulations and/or compliance standards

• Proactive, self-motivated, and adaptable to the evolving needs of a growing organization

• Strong problem-solving skills and ability to work independently

• Excellent relationship management and negotiation skills

• Ability to collaborate in a data-driven, customer focused team environment

• Experience working in a startup, scaling healthcare organization, fast-paced RCM environments, with multi-specialty practices or MSO structures preferred

• Certified Provider Credentialing Specialist (CPCS) certification, and Athena EHR experience is a plus

· Experience with multi-specialty practices or MSO structures preferred

Don’t feel like you have all the qualifications?

The description above indicates our current vision for the role. You could be a viable candidate even if you don’t fit everything we’ve described above and may also have important skills we haven’t thought of. If that’s you – even if you’re unsure – we encourage you to apply and help us get to know you!