Credentialing & Compliance Specialist
Anodyne, Milwaukee, WI, United States
Position Summary
The Compliance and Credentialing Manager is responsible for overseeing the organization’s regulatory compliance programs and managing all credentialing and licensing processes required for employees, contractors, providers, and facilities. This role ensures the company operates in full compliance with applicable federal, state, and local regulations while maintaining accurate credentialing records and audit-ready documentation.
The position serves as the central point of coordination for compliance oversight, credentialing verification, regulatory monitoring, and internal policy adherence.
Job Location:
This position is an on-site role working off our 5050 S 2nd St Milwaukee, WI 53207 facilities.
Pay Range:
$70,000-$80,000
Key Responsibilities:
Manage credentialing maintenance, including verification, tracking, and renewal of professional licenses, certifications, and regulatory credentials.
Conduct credentialing outreach to providers, partners, and stakeholders to ensure required documentation is obtained and maintained.
Review and maintain compliance updates, and regulatory log updates to ensure timely communication of regulatory changes.
Prepare and maintain ABC accreditation applications and supporting documentation binders, ensuring audit readiness and regulatory compliance.
Maintain and oversee the National Dispensing Log and ensure records meet applicable regulatory and accreditation standards.
Support insurance and Medicare compliance onboarding, ensuring documentation and regulatory requirements are met.
Compliance Monitoring & Performance Management
Conduct compliance audits and performance management reviews to ensure adherence to internal policies and regulatory requirements.
Manage complaint investigation, resolution, and response documentation in accordance with compliance protocols.
Prepare and distribute performance management and compliance reports for leadership review.
Monitor and analyze patient satisfaction feedback and identify areas requiring operational or compliance improvement.
Documentation, Training & Program Administration
Develop and maintain compliance documentation, forms, training materials, and internal resources, including SharePoint or shared document repositories.
Coordinate and administer annual employee compliance training programs, ensuring completion and documentation.
Assist internal teams and external customers with DME application processes and compliance requirements.
Provide customer audit support, compliance guidance, and re-training as required to maintain regulatory adherence.
Operational Support & Stakeholder Assistance
Provide customer or patient support related to compliance documentation, credentialing requirements, and regulatory troubleshooting.
Assist with insurance plan troubleshooting related to compliance, documentation, or credentialing matters.
Contribute to educational communications, newsletters, and compliance-related content when needed.
Additional Responsibilities
Support special compliance, credentialing, or regulatory projects as assigned.
Qualifications:
Bachelor’s degree in Healthcare Administration, Business Administration, Compliance, Legal Studies, or a related field required.
Experience working with regulated industries such as healthcare, medical devices, or insurance preferred.
Experience managing compliance programs or credentialing processes.
Certifications (Preferred)
Certified Compliance & Ethics Professional (CCEP)
Certified Provider Credentialing Specialist (CPCS)
Certified in Healthcare Compliance (CHC)
Key Competencies:
Strong knowledge of regulatory compliance frameworks.
Experience managing credentialing databases and verification processes.
Excellent attention to detail and documentation control.
Ability to manage audits, regulatory reviews, and compliance investigations
Strong organizational and project management skills.
Effective communication and cross-functional collaboration.
High level of discretion and confidentiality.
Working Conditions:
May require sitting for long periods and light lifting (up to 25 lbs).
Corporate office environment located in Milwaukee, Wisconsin.
Standard business hours with occasional extended hours to meet regulatory deadlines or audit requirements.
Occasional travel to branch locations in Oregon, and Florida is required.
The Compliance and Credentialing Manager is responsible for overseeing the organization’s regulatory compliance programs and managing all credentialing and licensing processes required for employees, contractors, providers, and facilities. This role ensures the company operates in full compliance with applicable federal, state, and local regulations while maintaining accurate credentialing records and audit-ready documentation.
The position serves as the central point of coordination for compliance oversight, credentialing verification, regulatory monitoring, and internal policy adherence.
Job Location:
This position is an on-site role working off our 5050 S 2nd St Milwaukee, WI 53207 facilities.
Pay Range:
$70,000-$80,000
Key Responsibilities:
Manage credentialing maintenance, including verification, tracking, and renewal of professional licenses, certifications, and regulatory credentials.
Conduct credentialing outreach to providers, partners, and stakeholders to ensure required documentation is obtained and maintained.
Review and maintain compliance updates, and regulatory log updates to ensure timely communication of regulatory changes.
Prepare and maintain ABC accreditation applications and supporting documentation binders, ensuring audit readiness and regulatory compliance.
Maintain and oversee the National Dispensing Log and ensure records meet applicable regulatory and accreditation standards.
Support insurance and Medicare compliance onboarding, ensuring documentation and regulatory requirements are met.
Compliance Monitoring & Performance Management
Conduct compliance audits and performance management reviews to ensure adherence to internal policies and regulatory requirements.
Manage complaint investigation, resolution, and response documentation in accordance with compliance protocols.
Prepare and distribute performance management and compliance reports for leadership review.
Monitor and analyze patient satisfaction feedback and identify areas requiring operational or compliance improvement.
Documentation, Training & Program Administration
Develop and maintain compliance documentation, forms, training materials, and internal resources, including SharePoint or shared document repositories.
Coordinate and administer annual employee compliance training programs, ensuring completion and documentation.
Assist internal teams and external customers with DME application processes and compliance requirements.
Provide customer audit support, compliance guidance, and re-training as required to maintain regulatory adherence.
Operational Support & Stakeholder Assistance
Provide customer or patient support related to compliance documentation, credentialing requirements, and regulatory troubleshooting.
Assist with insurance plan troubleshooting related to compliance, documentation, or credentialing matters.
Contribute to educational communications, newsletters, and compliance-related content when needed.
Additional Responsibilities
Support special compliance, credentialing, or regulatory projects as assigned.
Qualifications:
Bachelor’s degree in Healthcare Administration, Business Administration, Compliance, Legal Studies, or a related field required.
Experience working with regulated industries such as healthcare, medical devices, or insurance preferred.
Experience managing compliance programs or credentialing processes.
Certifications (Preferred)
Certified Compliance & Ethics Professional (CCEP)
Certified Provider Credentialing Specialist (CPCS)
Certified in Healthcare Compliance (CHC)
Key Competencies:
Strong knowledge of regulatory compliance frameworks.
Experience managing credentialing databases and verification processes.
Excellent attention to detail and documentation control.
Ability to manage audits, regulatory reviews, and compliance investigations
Strong organizational and project management skills.
Effective communication and cross-functional collaboration.
High level of discretion and confidentiality.
Working Conditions:
May require sitting for long periods and light lifting (up to 25 lbs).
Corporate office environment located in Milwaukee, Wisconsin.
Standard business hours with occasional extended hours to meet regulatory deadlines or audit requirements.
Occasional travel to branch locations in Oregon, and Florida is required.