[Hiring] Enrollment & Credentialing Coordinator @Nira Medical

Role Description

The Enrollment & Credentialing 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 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:
  • Ensure all providers are fully credentialed and enrolled in accordance with state, federal, and payer-specific regulations.
  • Maintain an accurate credentialing database, track expirations and renewals, and manage complete enrollment workflows with Medicare, Medicaid, and commercial payers.
  • Oversee CAQH maintenance, NPI and PECOS updates, and payer portal applications while monitoring enrollment timelines and following up with payers to prevent delays.
  • Keep all supporting documentation current, organized, and accessible to internal teams who rely on enrollment status for revenue readiness.
• Compliance & Regulatory Oversight:
  • Ensure compliance with all payer credentialing requirements and regulatory standards while maintaining clean, audit-ready credentialing files.
  • Prepare reports for leadership, support internal and external audits, and keep a centralized tracking system with real-time updates on application status.
  • Ensure that documentation, payer correspondence, and operational updates are consistently accurate, organized, and compliant.
• Provider & Payer Relationship Management:
  • Serve as a key liaison between providers, payers, and internal revenue cycle teams, facilitating timely issue resolution and clear communication.
  • Provide education to providers regarding reimbursement structures, contract terms, and credentialing expectations.
  • Ensure that both clinical and operational stakeholders understand the impact of payer requirements on revenue and compliance.
• Revenue Cycle & Operational Collaboration:
  • Partner closely with RCM teams to ensure provider enrollment and credentialing processes do not disrupt cash flow or claim submission readiness.
  • Identify and resolve credentialing-related payment issues, support onboarding for new providers and practice locations, and coordinate payer setup requirements with IT and EMR teams.
  • Escalate enrollment risks when needed to ensure operational continuity and financial performance during provider or location transitions.
• Location, Address, and Operational Updates:
  • Manage 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.
  • Submit required documentation, track payer acknowledgments or approvals, and ensure updates are fully processed to prevent revenue disruption.

Qualifications

• 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 and payer enrollment.
• Strong knowledge of payer credentialing requirements and individual/group 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.

Company Description

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!