Provider Relations Specialist

NORTH RANGE BEHAVIORAL HEALTH•Greeley, CO

8d•$21 - $30•Onsite

About The Position

At North Range Behavioral Health, expanding access to quality behavioral health services begins long before a client walks through our doors. As a Provider Relations Specialist, you play a vital role in ensuring our clinicians are credentialed, connected, and ready to serve the communities that rely on us. Working collaboratively across the organization, you coordinate and manager provider credentials with health insurance networks, cultivate strong relationships with payer partners, and help optimize processes that support timely access to care and sustainable revenue. Your expertise in navigating credentialing requirements, supporting insurance workflows, and fostering collaborative partnerships helps remove barriers that could delay services for those in need. Through your attention to detail, proactive communication, and commitment to excellence, you strengthen the foundation that allows our providers to focus on what matters most, delivering compassionate, high-quality behavioral health care in support of our mission to create hope, healing, and healthier communities.

Requirements

Associate’s Degree in Business Administration or related field, or an equivalent combination of education and experience
At least 2 years’ experience in a credentialing and/or contracting position, preferably in a behavioral/mental health agency, or a hospital, or health insurance agency.
Can pass a background check including FBI and CBI Fingerprinting, Drug and TB testing.

Nice To Haves

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

Responsibilities

Support timely access to behavioral health services by coordinating the onboarding, credentialing, enrollment, recredentialing, and offboarding of licensed providers across commercial insurance plans, Medicaid, Medicare, and other payer networks to ensure uninterrupted provider participation and reimbursement.
Manage the full provider credentialing lifecycle by preparing, submitting, tracking, and maintaining credentialing and recredentialing applications; verifying education, licensure, certifications, malpractice coverage, work history, and other required documentation while ensuring compliance with federal, state, payer, and accreditation requirements.
Maintain provider enrollment systems and databases by establishing and managing provider profiles in CAQH, Modio, and other credentialing platforms; ensuring information remains accurate, current, and complete to support credentialing, billing, and regulatory compliance.
Coordinate provider and organizational enrollment activities by maintaining National Provider Identifier (NPI) information, supporting organizational and facility NPI enrollment, completing Medicaid facility enrollments, managing provider affiliations with North Range Behavioral Health locations, and ensuring accurate provider roster participation across payer networks.
Monitor licensure, certifications, and compliance requirements by tracking renewal deadlines for professional licenses, liability insurance, DEA registrations (as applicable), credentialing cycles, and payer recredentialing requirements; communicating reminders and proactively addressing issues that could impact provider participation or client access to care.
Facilitate regulatory and payer compliance by researching and resolving credentialing discrepancies, responding to requests for additional documentation, managing situations involving licensing actions or restrictions, and coordinating with payers to maintain provider approval and participation.
Strengthen communication and collaboration by serving as a trusted resource for providers, clinical leadership, Human Resources, Billing, Contracting, the HOPE team, and health insurance representatives to resolve credentialing, enrollment, and contracting issues efficiently and accurately.
Build and maintain strong payer relationships through professional, responsive, and solution-focused communication that promotes timely credentialing decisions, effective problem-solving, and positive partnerships with insurance plans and regulatory agencies.
Drive continuous process improvement by documenting and enhancing credentialing, enrollment, and provider relations workflows; leveraging technology and reporting tools to improve efficiency, support revenue cycle performance, strengthen compliance, and enhance the provider experience.
Maintain accurate documentation and reporting by utilizing organizational systems, including Mediary and other designated applications, to facilitate information sharing, approvals, recordkeeping, and communication across departments while protecting confidential information.
Demonstrate flexibility and commitment to organizational success by supporting special projects, organizational initiatives, and additional responsibilities that advance North Range Behavioral Health's mission and strategic goals.