Provider Relations Specialist

NORTH RANGE BEHAVIORAL HEALTH•Greeley, CO

13d•$21 - $30•Onsite

About The Position

North Range Behavioral Health is hiring a Provider Relations Specialist for its Credentialing program in Greeley, Colorado. The role supports timely access to behavioral health services by coordinating providers’ onboarding, credentialing, enrollment, recredentialing, and offboarding across commercial insurance plans, Medicaid, Medicare, and other payer networks. The specialist manages credentialing applications and documentation, maintains provider records and profiles in credentialing systems, supports provider and organizational enrollment, and monitors licensure and other compliance deadlines. The role also resolves credentialing issues, builds relationships with payer partners, collaborates with internal teams, and improves processes that support compliance, provider experience, and revenue cycle performance. North Range Behavioral Health provides comprehensive, person-centered behavioral health and addiction care. Its work emphasizes collaboration, trauma-informed care, evidence-based practices, compassion, and customer-first service. The organization describes its vision as “Where Hope Begins, and Change Is Possible.”

Requirements

Bachelor’s degree or equivalent combination of education and experience is listed in the job details; the qualifications section also specifies an Associate’s degree in Business Administration or a related field, or an equivalent combination of education and experience.
At least two years of experience in a credentialing and/or contracting position; behavioral or mental health agency, hospital, or health insurance experience is preferred.
Ability to pass a background check, including FBI and CBI fingerprinting, drug testing, and TB testing.

Nice To Haves

Knowledge of provider credentialing and enrollment for commercial insurance plans, Medicaid, Medicare, and other payer organizations.
Experience creating and maintaining CAQH provider profiles and using Modio or similar credentialing management systems.
Knowledge of provider, organizational, and facility NPI requirements and payer enrollment processes.
Understanding of provider licensure requirements, malpractice or liability insurance, credentialing standards, and regulatory compliance.
Strong organizational skills, exceptional attention to detail, and ability to manage multiple priorities and deadlines.
Excellent written, verbal, and interpersonal communication skills and commitment to outstanding customer service.
Proficiency in Microsoft Excel, including formulas, formatting, and data management, and other Microsoft Office applications.
Ability to analyze information, solve problems, maintain accurate records, and handle confidential information with discretion.
Behavioral health, healthcare credentialing, or healthcare administration experience.

Responsibilities

Coordinate provider onboarding, credentialing, enrollment, recredentialing, and offboarding across commercial insurance plans, Medicaid, Medicare, and other payer networks.
Prepare, submit, track, and maintain credentialing and recredentialing applications; verify education, licensure, certifications, malpractice coverage, work history, and other required documentation.
Maintain accurate provider profiles in CAQH, Modio, and other credentialing platforms.
Maintain provider NPI information; support organizational and facility NPI enrollment; complete Medicaid facility enrollments; manage provider affiliations with North Range locations; and maintain accurate payer rosters.
Track renewal deadlines for professional licenses, liability insurance, DEA registrations as applicable, credentialing cycles, and payer recredentialing requirements; send reminders and proactively address issues.
Research and resolve credentialing discrepancies, respond to requests for additional documentation, address licensing actions or restrictions, and coordinate with payers to maintain provider approval and participation.
Serve as a resource for providers, clinical leadership, Human Resources, Billing, Contracting, the HOPE team, and insurance representatives to resolve credentialing, enrollment, and contracting issues.
Maintain responsive, solution-focused communication with payer partners and regulatory agencies to support timely decisions and effective problem-solving.
Document and improve credentialing, enrollment, and provider relations workflows, using technology and reporting tools to improve efficiency, compliance, revenue cycle performance, and provider experience.
Use Mediary and other designated applications for information sharing, approvals, recordkeeping, and cross-department communication while protecting confidential information.
Support special projects, organizational initiatives, and additional responsibilities that advance the organization’s mission and strategic goals.