Healthcare Credentialing & Provider Relations Specialist
About The Position
As the Healthcare Credentialing & Provider Relations Specialist, you'll keep provider credentialing, privileging, and payer enrollment accurate, current, and compliant for patient care at Reno-Sparks Tribal Health Center. This role exists to protect the integrity of provider records, support timely access to care, and ensure alignment with regulatory, accreditation, and payer standards. Responsibilities include processing initial and ongoing credentialing/re-credentialing files; verifying licensure, education, training, certifications, malpractice history, and references; maintaining provider data and tracking expirations; coordinating commercial payer contracts and enrollments with NextGen RCM Credentialing; reviewing provider contracts and job descriptions for completeness and compliance; maintaining revision/approval documentation; and serving as a liaison to support TMFQHC written care coordination agreements (WCCA).
Requirements
- High School Diploma/GED (required)
- 3+ years relevant credentialing experience (required)
- Familiarity with CAQH/Health Stream
- Strong organization skills
- Strong communication skills
- Strong analytical skills
Nice To Haves
- Associate's degree (preferred)
Responsibilities
- Processing initial and ongoing credentialing/re-credentialing files
- Verifying licensure, education, training, certifications, malpractice history, and references
- Maintaining provider data and tracking expirations
- Coordinating commercial payer contracts and enrollments with NextGen RCM Credentialing
- Reviewing provider contracts and job descriptions for completeness and compliance
- Maintaining revision/approval documentation
- Serving as a liaison to support TMFQHC written care coordination agreements (WCCA)
Benefits
- Medical: Hometown Health PPO
- Dental: Lincoln Dental
- Vision: Lincoln Vision
- Life Insurance
- Paid Time Off: Annual leave accrues 4 hours per pay period
- Sick Leave: Accrues 4 hours per pay period
- Paid Holidays: 13 paid holidays per year
- 401(k): Eligible for employee contributions after 60 days; discretionary RSIC contribution; employer matching begins after 1 year of full-time employment
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
