Overview
Nira Medical is a national partnership of physician-led, patient-centered independent practices committed to driving the future of neurological care. Nira's mission is to enable clinicians to provide access to life-changing treatments so you can provide the best possible patient outcomes. Founded by neurologists who understand the unique challenges of the field, Nira Medical supports practices with cutting-edge technology, clinical research opportunities, and a collaborative and comprehensive care network dedicated to advancing the standard of care. As we enter the next phase of growth, our focus is on scaling our teams, services, and elevating the customer experience!
This is where you come in…
The RCM Credentialing & Contracts Lead is responsible for managing provider credentialing, payer contracting, and compliance to support Nira’s streamlined revenue cycle operations. This role ensures timely provider enrollment, contract execution, and adherence to payer requirements while proactively addressing credentialing-related denials and revenue-impacting gaps. As a key operational lead in a growing RCM structure, this position requires a hands-on, process-driven mindset with the ability to problem-solve, build scalable workflows, and foster strong relationships with providers, payers, and internal teams. As a culture add , this role is ideal for someone who thrives in a fast-paced, startup-minded environment and can help scale provider and payer operations with efficiency and structure.
Here’s what you’ll be doing…
· Provider Credentialing & Enrollment: Ensuring compliance with state, federal, and payer-specific credentialing regulations. Maintaining an up-to-date credentialing database with expiration alerts and renewal tracking
· Payer Contracting & Rate Management: Tracking contract renewal deadlines and ensure providers are contracted at optimal reimbursement rates. Analyzing payer agreements to identify opportunities for revenue optimization and improved terms
· Compliance & Regulatory Oversight: Ensuring compliance with payer credentialing, contract requirements, and regulatory standards. Supporting internal and external audits related to credentialing and provider enrollment
· Provider & Payer Relationship Management: Serve as the liaison between providers, payers, and the revenue cycle team to address credentialing and contracting issues. Provide ongoing education to providers about contract terms, reimbursement structures, and compliance expectations
· Revenue Cycle & Operational Collaboration: Working closely with RCM specialist teams to ensure provider enrollments do not impact cash flow. Identifying root causes of credentialing-related payment delays and implement corrective actions
Here’s what we’re looking for…
· Associate’s/bachelor’s degree in healthcare administration, business, or a related filed; or equivalent relevant experience in credentialing, payer contracting, or healthcare operations
· Minimum 3+ years of experience in revenue cycle management, healthcare regulations and/or compliance standards
· Strong knowledge of payer credentialing requirements, fee schedules, and contract structures
· Prior experience in healthcare revenue cycle, medical billing, or payer relations
· 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
· Experience working in a startup, scaling healthcare organization, or fast-paced RCM environment is a plus
· Certified Provider Credentialing Specialist (CPCS) certification is a plus
Don’t feel like you have all the qualifications?
The description above indicates our current vision for the role. You could be a viable candidate even if you don’t fit everything we’ve described above and may also have important skills we haven’t thought of. If that’s you – even if you’re unsure – we encourage you to apply and help us get to know you!
