Credentialing & Compliance Lead

🕒 il y a 26 jours

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Rx Redefined

Site WebLinkedInTous les Emplois

51 - 200 employés

Fondée en 2018

☁️ SaaS

🤝 B2B

📋 Conformité

💰 €21 492 494 Series B - Rx Redefined en 2024-12

SaaS • B2B • Compliance

Rx Redefined est une plateforme DMEPOS axée sur la conformité, permettant aux cabinets médicaux détenus par des médecins de gérer la licence, les commandes, la chaîne d'approvisionnement, la facturation et les flux de travail d'audit pour les équipements médicaux durables, les prothèses, les orthèses et les fournitures. L'entreprise propose un système breveté basé sur SaaS avec des connexions intégrées aux centres de distribution, une gestion du cycle des revenus, un support d'audit routinier et un service de conformité en tant que service, construit sur une infrastructure ISO 27001 et des contrôles HIPAA. Fiable pour plus de 350 cliniques et distribuant des millions de produits chaque année, Rx Redefined réduit le temps de mise en service, empêche le changement de produit motivé par des raisons financières et centralise la conformité aux réglementations et à la facturation pour les fournisseurs médicaux.

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

🎯 Exigences

• 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

🏖️ Avantages

• 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.