Enrollment & Credentialing Coordinator

Overview

Nira Medical is a national partnership of physician-led, patient-centered independent practices. It aims to drive the future of neurological care by enabling clinicians to provide access to life-changing treatments, supporting practices with cutting-edge technology, clinical research opportunities, and a collaborative care network.

About the role

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.

Responsibilities

• Ensures all providers are fully credentialed and enrolled in accordance with state, federal, and payer-specific regulations.
• Maintains an accurate credentialing database, tracks expirations and renewals, and manages complete enrollment workflows with Medicare, Medicaid, and commercial payers.
• Oversight of CAQH maintenance, NPI and PECOS updates, and payer portal applications while monitoring enrollment timelines and following up with payers to prevent delays.
• Keeps all supporting documentation current, organized, and accessible to internal teams who rely on enrollment status for revenue readiness.
• Ensures compliance with all payer credentialing requirements and regulatory standards while maintaining clean, audit-ready credentialing files.
• Serves as a key liaison between providers, payers, and internal revenue cycle teams, facilitating timely issue resolution and clear communication.
• Provides education to providers regarding reimbursement structures, contract terms, and credentialing expectations, ensuring both clinical and operational stakeholders understand the impact of payer requirements on revenue and compliance.
• Pairs closely with RCM teams to ensure provider enrollment and credentialing processes do not disrupt cash flow or claim submission readiness.
• 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.

Requirements

• 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.
• 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.

Preferred Qualifications

• 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.