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Credentialing & Compliance Lead

Remote · Senegal Full-time

About the role The Credentialing & Compliance Lead serves as the end-to-end owner of Medicare DMEPOS credentialing, acting as both a subject matter expert and operational driver. This role is responsible for navigating complex regulatory requirements, managing high-impact customer interactions, and ensuring all licensing activities are executed with precision, speed, and full compliance. You will operate cross-functionally, influence process improvements, and play a critical role in enabling our customers to successfully launch and maintain compliant operations. Duties & Responsibilities

  • 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

Core Qualifications

  • 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

How You Operate

  • Highly organized with strong attention to detail
  • Compliance-driven with sound judgment
  • Analytical and solution-oriented
  • Clear communicator with a customer-focused approach
  • Self-sufficient and accountable; able to work independently
  • Experienced in process coordination and documentation
  • Maintains strict confidentiality

Preferred

  • Experience with MACs (Novitas, Palmetto)
  • Familiarity with PECOS, NPPES, and/or EMR systems
  • Exposure to DMEPOS credentialing requirements

Benefits & Perks

  • 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.

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