Sr. Advisor, Supplier Enrollment & Credentialing (Medicare)

Accountabilities

- Lead and independently manage end-to-end Medicare enrollment and credentialing activities across five DMEPOS business entities, including initial applications, revalidations, changes of information, new location openings and closures, and changes of ownership.

- Prepare, submit, and manage enrollment applications through CMS-855S, PECOS, and NPPES, ensuring accuracy and compliance with applicable requirements.

- Serve as the primary contact for Medicare Administrative Contractors and enrollment authorities, including Palmetto GBA, Novitas, and DME MACs, managing enrollment inquiries, site visits, and deficiency responses.

- Ensure ongoing compliance with Medicare DMEPOS supplier standards, accreditation requirements, liability insurance certificates, surety bond obligations, and applicable state licensing requirements.

- Monitor revalidation schedules, application deadlines, Provider Transaction Access Numbers (PTANs), and National Provider Identifier (NPI) records to maintain uninterrupted Medicare billing privileges.

- Lead responses to enrollment revocations, deactivations, requests for information, and corrective action plans, including appeals and reconsideration requests when necessary.

- Develop enrollment strategies, implementation timelines, and risk assessments to support acquisitions, new facility launches, ownership changes, and other organizational developments.

- Monitor CMS regulatory updates and industry developments, assess their operational implications, and recommend appropriate actions to maintain compliance.

- Establish and maintain credentialing policies, procedures, tracking systems, and supporting documentation to ensure audit readiness.

- Identify potential enrollment and regulatory risks proactively, providing senior leadership with practical recommendations and mitigation strategies.

- Present enrollment performance updates, compliance concerns, and strategic recommendations to senior stakeholders.

- Collaborate with Compliance, Legal, Regulatory, Revenue Cycle, and Operations teams to align enrollment activities with business requirements.

- Drive continuous improvement by standardizing workflows and enhancing enrollment processes across multiple entities and locations.

Requirements

- At least 8 years of experience in Medicare provider or supplier enrollment, preferably with direct experience managing DMEPOS enrollment across multiple entities or locations.

- Bachelor's degree or equivalent professional experience preferred.

- Extensive knowledge of government credentialing and enrollment processes, including direct interaction with federal or state agencies and their contractors.

- Advanced hands-on expertise in Medicare DMEPOS enrollment requirements, including CMS-855S, PECOS, NPPES, supplier standards, accreditation, surety bonds, revalidations, and changes of ownership.

- Previous experience managing Medicare DMEPOS supplier enrollments within a DME supplier organization or working with CMS, Palmetto GBA, Novitas, or a DME MAC is strongly preferred.

- Strong understanding of Medicare regulations and the ability to interpret, anticipate, and respond to evolving CMS requirements.

- Demonstrated ability to work independently, exercise sound judgment, and assess regulatory risks in relation to broader business objectives.

- Exceptional attention to detail, accuracy, and compliance, particularly when managing complex documentation and regulatory deadlines.

- Strong organizational and time-management skills, with the ability to manage high volumes of work and competing priorities.

- Excellent written and verbal communication skills, including the ability to explain complex regulatory matters clearly to senior leadership.

- Strong stakeholder management and collaboration skills, with the confidence to interact with external regulatory authorities and internal executives.

- Experience supporting acquisitions, multi-entity enrollment strategies, or large-scale organizational transitions is an advantage.

- Professional certifications such as CPCS, CPMSM, or equivalent credentialing qualifications are considered a plus.

Benefits

- Annual salary: $89,000–$147,550, depending on experience, qualifications, skills, and geographic location.

- Performance-based bonus eligibility.

- Medical, dental, and vision insurance coverage.

- Paid time off.

- Health Savings Account (HSA).

- Flexible Spending Accounts (FSAs).

- 401(k) retirement savings plan.

- Early access to earned wages through myFlexPay.

- Short-term and long-term disability coverage.

- Paid parental leave.

- Work-life support resources.

- Healthy lifestyle and wellness programs.

- Opportunity to work in a nationwide remote position.

- Professional development opportunities within a large-scale healthcare and medical supply environment.

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