Provider Relations Specialist

North Range Behavioral Health; Greeley (CO); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Generous PTO

Paid holidays

Medical, dental, and vision plans

Health Reimbursement Account

Retirement plan with employer contribu

Loan forgiveness opportunities

Professional development opportunities

Job summary

North Range Behavioral Health in Greeley, CO seeks a Provider Relations Specialist to manage onboarding, credentialing, enrollment, recredentialing, and offboarding of licensed clinicians across commercial plans, Medicaid, and Medicare. You will maintain CAQH and Modio profiles, track renewals, and support payer enrollment.

You will coordinate NPI enrollment, ensure data accuracy, and build strong relationships with payers and internal teams to optimize access to care and reimbursement.

Qualifications

• 2+ years’ experience in credentialing and/or contracting, preferably in behavioral/mental health or hospital/insurance setting.
• Knowledge of provider credentialing and enrollment for commercial plans, Medicaid, Medicare and other payers.
• Familiarity with CAQH provider profiles and credentialing management systems such as Modio or similar platforms.

Responsibilities

• Coordinate onboarding, credentialing, enrollment, recredentialing, and offboarding of licensed providers across commercial plans, Medicaid, Medicare and other payer networks.
• Manage full credentialing lifecycle: prepare, submit, track, and maintain applications; verify education, licensure, certifications, malpractice, work history and other docs.
• Maintain provider enrollment systems and databases; manage provider profiles in CAQH, Modio, and other platforms; ensure data is current and compliant.
• Coordinate NPI enrollment activities; support facility enrollment and affiliations; ensure roster participation across payers.
• Track renewal deadlines and compliance requirements; address issues affecting participation or access to care.
• Research and resolve credentialing discrepancies; respond to additional documentation requests; manage licensing actions with payers.
• Build strong payer relationships via professional communication to promote timely credentialing decisions.
• Document and improve credentialing workflows using technology and reporting tools to support revenue cycle and compliance.

Skills

CAQH provider profiles

Modio credentialing

NPI enrollment

Provider licensure knowledge

Regulatory compliance

Excel proficiency

Communication skills

Organizational skills

Education

Associate’s Degree in Business Administration or related field

Equivalent combination of education and experience

Tools

Modio

CAQH

Job description

Provider Relations SpecialistNorth Range Behavioral HealthProgram: CredentialingEducation Requirements: Bachelor’s degree or equivalent combination of education and experienceEmployment Type: Full-TimeLocation: Greeley, COPosting Closes: 11.30.2026At North Range Behavioral Health, we believe no one should face mental health challenges alone. Our compassionate team provides comprehensive, person-centered care, supporting individuals, families, and communities to thrive. We’re proud to be a leader in behavioral health services across Weld County, offering programs for all ages and backgrounds. Our work is grounded in collaboration, trauma-informed care, and evidence-based practices, creating meaningful, lasting impact every day.Why North Range Behavioral Health?Because your work should matter – and here, it truly does!Vision: Where Hope Begins, and Change Is PossibleMission: North Range Behavioral Health provides compassionate, comprehensive care for people who face mental health and addiction challenges.Values:Customer First: We help our customers achieve recovery every day.Compassion: We treat everyone with kindness, empathy, and dignity.Collaboration: We build strong relationships, internally and externally, to ensure effective care for our customersAbout the Role: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.What You Will Do: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.You’re a Great Fit If You:Have an Associate’s Degree in Business Administration or related field, or an equivalent combination of education and experienceHave 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.Preference will be given to candidates who: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.Perks and Benefits:Generous PTO and paid holidaysMultiple medical, dental, and vision plans at no cost to employeesHealth Reimbursement AccountRetirement plan with employer contributionsLoan forgiveness opportunitiesEmployee referral bonusesProfessional development opportunitiesOur Commitment to Equity:North Range Behavioral Health is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to fostering an inclusive, equitable, and supportive workplace for all. We welcome applicants of every background, including race, color, religion, gender, gender identity or expression, sexual orientation, national origin, disability, veteran status, and all other legally protected characteristics. We believe a diverse team strengthens our ability to serve our community.