COMPLIANCE MANAGER at Distro – Mérida, Baja California

Provider Enrollment, Licensing & Credentialing Specialist

Responsibilities:

Manage end-to-end state licensing, credentialing, Medicaid and Medicare enrollment, insurance applications, and regulatory documentation for home care, home health, and hospice agencies.

Supervise the execution and administration of all Provider Enrollment contracts.

Support Sales team with commercial calls, contract review and issuance.

Address and resolve client inquiries, complaints, investigations, and clarifications.

Act as Application Traffic Coordinator.

Prepare and oversee monthly reports including Financial Liability Report, Application Tracker, and Submission/Approval Reports.

Handle state-specific issues with Ombudsman Offices and State Supervisors/Directors.

Draft and update Medicaid Waiver application policies and procedures.

Conduct state and program regulatory research to support internal teams and sales.

Review and prepare Corrective Action Plans and required state authority documentation.

Complete licensing, credentialing, and provider enrollment applications fully.

Process documentation accurately on state and agency portals.

Communicate with clients to gather required documentation per state.

Stay updated on state regulations and insurance program requirements.

Maintain application documentation, requirements, and status in CRM and trackers.

Review applications to ensure completeness and accuracy before submission.

Educate clients on timelines, requirements, and expectations throughout processes.

Prioritize and manage incoming customer calls.

Enter new contracts into CRM (Nutshell).

Scan, upload, and organize client documents on Shared Drive.

Create, audit, and correct monthly reports.

Process application cancellations and termination agreements.

Manage emails and reception tasks.

Provide support with copying, faxing, mailing, and internal meetings.

Schedule:

Monday to Friday

8:00 AM 6:00 PM (EST)

Education & Experience:

High school diploma or GED.

1 to 2 years of experience in licensing, credentialing, provider enrollment, compliance, or legal research.

Experience in home care, home health, or hospice sectors.

Proven ability to manage high volume caseloads and meet deadlines.

Knowledge of regulatory research or state compliance is a plus.

Technical Skills:

Proficient with Microsoft 365 and Microsoft Office.

Intermediate Adobe Acrobat skills.

Experience with CRM systems (Nutshell preferred; Salesforce desirable).

Strong research skills in state government portals.

Ability to quickly learn new systems and workflows.

Experience documenting processes and maintaining detailed trackers.

Soft Skills:

High attention to detail and organizational skills.

Excellent written and verbal communication in English.

Customer service oriented with professional demeanor.

Ability to interpret complex regulations and guidelines.

Logical thinking and strong problem-solving skills.

Ability to work independently and collaboratively.

Resilience in fast-paced, high-volume environments.

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