Sr. Advisor, Supplier Enrollment & Credentialing (Medicare) in United States at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Sr. Advisor, Supplier Enrollment & Credentialing (Medicare) based in the United States.

As a Senior Advisor, Supplier Enrollment & Credentialing, you will lead Medicare enrollment and credentialing activities across multiple durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) business entities. You will serve as the subject matter expert, ensuring regulatory compliance, maintaining supplier eligibility, and protecting uninterrupted access to Medicare billing privileges. This role offers the opportunity to manage complex enrollment processes while advising senior leadership on regulatory developments and business risks. You will collaborate closely with Legal, Compliance, Operations, Regulatory, and Revenue Cycle teams to support organizational priorities. Working independently, you will oversee critical enrollment activities, anticipate regulatory challenges, and develop scalable processes. This is an impactful opportunity for an experienced professional to contribute to healthcare operations and ensure continued access to essential medical supplies for patients.

• 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.

• 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.

• 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.