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.
ADA/EEO: The employer will make reasonable accommodations in compliance with the American Disabilities Act of 1990. Rx Redefined provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.