Credentialing Specialist

About the roleThe Credentialing Specialist 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 & ResponsibilitiesOwn the full DMEPOS credentialing lifecycle, including new enrollments, revalidations, reactivations, updates, and ongoing maintenanceTrack and manage application status to ensure timely and accurate submissionsMaintain complete and audit-ready documentation aligned with regulatory standardsMonitor and interpret federal and state regulatory requirements, ensuring continuous complianceProactively implement updates to internal processes, policies, and documentation as requirements evolveAct as a safeguard for compliance risk across all credentialing activitiesServe as the primary liaison with Medicare Administrative Contractors (MACs) and other regulatory bodiesPartner cross-functionally with internal teams to drive credentialing timelines and remove blockersLead customer-facing interactions to guide providers through licensing requirements and expectationsDevelop, maintain, and continuously improve Credentialing SOPs and documentation standardsIdentify inefficiencies and implement scalable solutions to improve turnaround times and accuracyLead data collection efforts to support reporting, tracking, and performance optimizationServe as the internal credentialing expert, advising teams on requirements, risks, and best practicesSupport onboarding and training initiatives related to credentialing processesFacilitate onsite customer ID verification processes as neededAbility to travel up to 20%, nationwideCore QualificationsAssociate’s degree required; Bachelor’s preferred2+ years in healthcare credentialing, Medicare enrollment, or regulated compliance environmentsExperience working cross-functionally to drive outcomesHow You OperateHighly organized with strong attention to detailCompliance-driven with sound judgmentAnalytical and solution-orientedClear communicator with a customer-focused approachSelf-sufficient and accountable; able to work independentlyExperienced in process coordination and documentationMaintains strict confidentialityPreferredExperience with MACs (Novitas, Palmetto)Familiarity with PECOS, NPPES, and/or EMR systemsExposure to DMEPOS credentialing requirementsBenefits & PerksMedical, 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.

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