Credentialing & Compliance Lead
Rx Redefined
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Own the full DMEPOS credentialing lifecycle, including new enrollments, revalidations, reactivations, updates, and ongoing maintenance
- Track and manage application status to ensure timely and accurate submissions
- Maintain complete and audit-ready documentation aligned with regulatory standards
- Monitor and interpret federal and state regulatory requirements, ensuring continuous compliance
- Proactively implement updates to internal processes, policies, and documentation as requirements evolve
- Act as a safeguard for compliance risk across all credentialing activities
- Serve as the primary liaison with Medicare Administrative Contractors (MACs) and other regulatory bodies
- Partner cross-functionally with internal teams to drive credentialing timelines and remove blockers
- Lead customer-facing interactions to guide providers through licensing requirements and expectations
- Develop, maintain, and continuously improve Credentialing SOPs and documentation standards
- Identify inefficiencies and implement scalable solutions to improve turnaround times and accuracy
- Lead data collection efforts to support reporting, tracking, and performance optimization
- Serve as the internal credentialing expert, advising teams on requirements, risks, and best practices
- Support onboarding and training initiatives related to credentialing processes
- Facilitate onsite customer ID verification processes as needed
- Ability to travel up to 20%, nationwide
Requirements
- Associate’s degree required; Bachelor’s preferred
- 2+ years in healthcare credentialing, Medicare enrollment, or regulated compliance environments
- Experience working cross-functionally to drive outcomes
Benefits
- Medical, dental, and vision coverage - 100% of the employee premium is covered by Rx Redefined.
- Professional growth - be part of a high-growth team where you’ll learn quickly and see the impact of your work.
- Bonus program eligible.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
credentialingDMEPOSMedicare enrollmentregulatory compliancedocumentation standardsSOP developmentdata collectionperformance optimizationapplication trackingaudit readiness
Soft Skills
communicationcross-functional collaborationproblem-solvingleadershipcustomer serviceorganizational skillsattention to detailrisk managementtrainingprocess improvement
Certifications
Associate’s degreeBachelor’s degree