Senior Advisor, Supplier Enrollment & Credentialing, Medicare

This is a fully remote position, open to applicants in United States.

📋 Description

• Take full ownership and execute the complete Medicare enrollment process for five DMEPOS entities, which includes initial enrollments, revalidations, changes of information, site openings and closures, as well as changes of ownership via CMS-855S, PECOS, and NPPES.

• Act as the main point of contact for Palmetto GBA, Novitas, and the DME MACs regarding enrollment issues, site visits, and responses to deficiencies.

• Ensure that entities and locations comply with DMEPOS supplier standards, accreditation mandates, insurance liability certificates, surety bond requirements, and state licensing obligations.

• Oversee revalidation cycles, deadlines, PTANs, and NPI records to avoid interruptions in billing privileges.

• Lead efforts in managing revocations, deactivations, information requests, and corrective action plans, including application appeals and reconsiderations.

• Formulate enrollment strategies, timelines, and risk assessments for acquisitions, new site launches, and other organizational changes.

• Keep abreast of CMS regulatory updates and industry changes, evaluate their impacts, and suggest business responses.

• Create and maintain credentialing policies, procedures, tracking tools, and documentation to ensure the organization remains audit-ready.

• Identify enrollment risks and offer pragmatic recommendations to leadership.

• Provide status updates, assess risks, and suggest strategic recommendations to senior leaders.

• Collaborate with Compliance, Legal, Regulatory, Revenue Cycle, and Operations teams.

• Promote continuous improvement and standardization of enrollment processes across all entities.

⛳️ Requirements

• A minimum of 8 years of experience in Medicare provider or supplier enrollment.

• Preferably possess direct, hands-on experience in successfully managing DMEPOS enrollment for a multi-entity or multi-location organization.

• A Bachelor’s degree or equivalent experience is preferred.

• Certifications such as CPCS, CPMSM, or similar are advantageous.

• Significant experience with governmental credentialing and enrollment processes for suppliers or institutions, including direct dealings with federal or state agencies and their contractors.

• Extensive, hands-on knowledge in Medicare DMEPOS enrollment, encompassing CMS-855S, PECOS, NPPES, supplier standards, accreditation, surety bonds, revalidations, and changes of ownership.

• Direct experience in managing Medicare DMEPOS supplier enrollments within a DME supplier organization or with CMS, Palmetto GBA, Novitas, or a DME MAC is highly preferred.

• Demonstrated ability to navigate complex regulatory landscapes and stay updated on changing CMS requirements.

• Capability to work autonomously, exercise sound judgment, and think strategically regarding enrollment risks and business impacts.

• Strong compliance mindset with a keen eye for detail and accuracy.

• Executive presence with the ability to clearly communicate complex regulatory information to senior leadership.

• Outstanding organizational skills and the ability to manage a high volume of work with tight deadlines across competing priorities.

• Experience in supporting acquisitions or developing multi-entity enrollment strategies is a plus.

🏝️ Benefits

• Bonus eligibility.

• Medical, dental, and vision coverage.

• Paid time off plan.

• Health savings account (HSA).

• 401k savings plan.

• Access to wages in advance with myFlexPay.

• Flexible spending accounts (FSAs).

• Short- and long-term disability coverage.

• Work-Life resources.

• Paid parental leave.

• Healthy lifestyle programs.