Credentialing & Compliance Lead
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.