Healthcare Credentialing & Provider Relations Specialist

Job Description

Job Description

Our Community Roots

The Reno-Sparks Indian Colony represents descendants of three Great Basin Indigenous peoples: the Numu (Northern Paiute) , Newe (Western Shoshone) , and Washeshu (Washoe) . These communities lived in harmony with the land for generations before European contact, following seasonal cycles and forming small, efficient social groups for survival.

Each group's name means "The People" in their own language, reflecting their deep cultural identity and connection to the Earth. They maintained strong traditions, respected neighboring tribes, and engaged in trade throughout the region.

Today, the Reno-Sparks Indian Colony continues to honor these traditions while supporting the well-being, culture, and future of its tribal community. Key Role Summary

As the Healthcare Credentialing & Provider Relations Specialist, you'll keep provider credentialing, privileging, and payer enrollment accurate, current, and compliant for patient care at Reno-Sparks Tribal Health Center. This role exists to protect the integrity of provider records, support timely access to care, and ensure alignment with regulatory, accreditation, and payer standards.

Responsibilities include processing initial and ongoing credentialing/re-credentialing files; verifying licensure, education, training, certifications, malpractice history, and references; maintaining provider data and tracking expirations; coordinating commercial payer contracts and enrollments with NextGen RCM Credentialing; reviewing provider contracts and job descriptions for completeness and compliance; maintaining revision/approval documentation; and serving as a liaison to support TMFQHC written care coordination agreements (WCCA).

Qualifications:
- High School Diploma/GED (required); Associate's degree (preferred)
- 3+ years relevant credentialing experience (required)
- Familiarity with CAQH/Health Stream, strong organization, communication, and analytical skills

Apply to help ensure providers are ready to serve our community with confidence. A Day, Start to Finish

You'll begin onsite by checking your credentialing tracker for upcoming renewals and any items awaiting verification, then update records in the appropriate databases so files stay audit-ready. Midday often includes coordinating with NextGen RCM Credentialing on payer status updates, following up for missing documentation, and clarifying details that keep timelines moving.

As the day unfolds, you may review a contract packet for accuracy and routing history, log key dates, and confirm the latest version is properly documented. You'll also connect with internal partners and outside specialty offices-by phone or brief visits-to keep written care coordination agreements progressing smoothly. You'll wrap up by documenting resolutions, flagging next steps, and organizing priorities for the next business day. Your Total Rewards

- Medical: Hometown Health PPO (RSIC contribution varies by tier: Employee Only 100%; Employee & Spouse 50%; Employee & Child(ren) 65%; Family 60%)
- Dental: Lincoln Dental (RSIC contribution varies by tier: Employee Only 100%; Employee & Spouse 50%; Employee & Child(ren) 65%; Family 60%)
- Vision: Lincoln Vision (RSIC contribution varies by tier: Employee Only 100%; Employee & Spouse 50%; Employee & Child(ren) 65%; Family 60%)
- Life Insurance
- Paid Time Off: Annual leave accrues 4 hours per pay period (usable after probation; increases after 5 years per policy)
- Sick Leave: Accrues 4 hours per pay period (available immediately)
- Paid Holidays: 13 paid holidays per year
- 401(k): Eligible for employee contributions after 60 days; discretionary RSIC contribution; employer matching begins after 1 year of full-time employment

Please Note: Hiring preference is provided to qualified members of the Reno-Sparks Indian Colony followed by members of other federally recognized tribes. Reno-Sparks Indian Colony requires any designated candidate to complete a pre-employment criminal background check, drug screen, and confirmation of professional references.