Credentialing & Compliance Lead

🕒 4 days ago

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Rx Redefined

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

☁️ SaaS

🤝 B2B

📋 Compliance

💰 $21.5M Series B - Rx Redefined on 2024-12

SaaS • B2B • Compliance

Rx Redefined is a compliance-focused DMEPOS platform that enables physician-owned practices to manage licensing, ordering, supply chain, billing, and audit workflows for durable medical equipment, prosthetics, orthotics, and supplies. The company provides a patented, SaaS-based system with integrated distribution center connections, revenue-cycle management, routine audit support, and Compliance-as-a-Service built on ISO 27001 infrastructure and HIPAA controls. Trusted by 350+ clinics and distributing millions of products annually, Rx Redefined reduces time-to-service, prevents financially motivated product switching, and centralizes regulatory and billing compliance for physician suppliers.

📋 Description

• 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 • 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

🏖️ 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.