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The compliance-focused DMEPOS platform for physicians.
Credentialing & Compliance Lead
Location
United States
Posted
49 days ago
Salary
0
Seniority
Lead
No structured requirement data.
Job Description
Credentialing & Compliance Lead
Rx Redefined
Role Description 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. 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 - 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.
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TripadvisorTripadvisor, founded in 2000, is an award-winning network for travel information that features real advice from global travelers. The world’s largest travel s
Compliance Manager Dublin Compliance Manager Deputy to the Chief Compliance Officer & MLRO Owl Payments Europe – Dublin 4 days per week in the office About Tripadvisor The Tripadvisor Group connects people to experiences worth sharing and aims to be the world’s most trusted source for travel and experiences. Through its portfolio of brands including Tripadvisor, Viator, Owl Payments and TheFork, the Group leverages technology, trusted content, and global partnerships to connect millions of travellers with experiences, accommodations, restaurants, and travel services. Owl Payments Europe Limited (OPEL) is the regulated Payment Institution authorised by the Central Bank of Ireland (CBI), supporting the Tripadvisor marketplace ecosystem across Europe. OPEL is subject to the full scope of CBI supervisory requirements, including safeguarding, AML/CFT, outsourcing governance, and applicable Fitness and Probity, Conduct Standards, and Individual Accountability Framework requirements. Why this job is excellent Owl Payments Europe is seeking an experienced Compliance Manager to act as Deputy to the Chief Compliance Officer and Money Laundering Reporting Officer (PCF-12 and PCF-52). This is a non-PCF operational role. The CCO/MLRO retains primary regulatory accountability to the Central Bank of Ireland, and the Compliance Manager acts in a delegated capacity in support of that function. Reporting directly to the CCO/MLRO, the Compliance Manager will provide operational leadership across OPEL's regulatory compliance and AML/CFT framework, drive the compliance monitoring programme, support regulatory engagement, and ensure compliance obligations are understood and embedded across the organisation. 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Outsourcing and Third-Party Compliance - Provide compliance oversight of OPEL's outsourcing arrangements in accordance with EBA Guidelines on Outsourcing Arrangements and CBI expectations. - Maintain the outsourcing register and support the assessment of material outsourcing and sub-outsourcing arrangements. - Monitor compliance of material service providers against contractual and regulatory standards. 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Proven integrity and demonstrable adherence to CBI Fitness and Probity standards. - Strong working knowledge of the Irish and EU regulatory frameworks applicable to payment institutions, including SI 6/2018, the Criminal Justice (Money Laundering and Terrorist Financing) Acts 2010 to 2024, as amended, CBI AML/CFT Guidelines and FATF standards. - Experience implementing compliance monitoring programmes and AML/CFT risk assessments. - Sound understanding of EBA Guidelines on Outsourcing Arrangements and CBI outsourcing expectations. - Familiarity with applicable Fitness and Probity, Conduct Standards, and Individual - Accountability Framework requirements as they apply to regulated firms in Ireland. - Ability to work effectively with cross-functional teams in a technology-enabled payments environment. - Excellent analytical, written, and verbal communication skills, with the ability to translate complex regulatory requirements into clear, practical advice for business leaders and operational teams Essential requirements - Degree in Law, Finance, Business, Compliance, Risk Management, or a related field. - Professional compliance, AML, or financial crime certification is required or must be obtained within an agreed timeframe. Acceptable qualifications include the ICA - Diploma in Compliance, ICA Certificate in AML, or ACAMS/CAMS certification. - Demonstrated experience in regulatory compliance, AML, or financial crime within a regulated financial services or payments environment. - Knowledge of PSD2, Irish Payments Regulations, AML/CFT requirements, and - Central Bank of Ireland supervisory expectations. - Experience preparing regulatory or compliance reporting. - Ability to work effectively with senior management, operational teams, and external regulators. Why join Owl Payments Europe This is an opportunity to play a meaningful role in the compliance leadership of a CBI- regulated Payment Institution operating within a global travel and experiences marketplace. You will work closely with senior leadership and gain broad exposure to regulatory strategy, payments infrastructure, financial crime risk management, and cross-border regulatory engagement. 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