Part-Time Provider Enrollment & Credentialing Specialist

CEC Health Care; Bethpage (NY); On-site; USD 34,440 - 41,328; Part time

Job summary

CEC Healthcare, a not-for-profit Federally Qualified Health Center (FQHC), seeks a part-time Provider Enrollment Specialist in Bethpage, NY to support provider credentialing, enrollment, affiliation, and data management across Medicare, Medicaid NY eMedNY, and commercial plans.

You will ensure compliance with state/federal regulations and assist with onboarding, credentialing maintenance, and reimbursement readiness. Flexible day shift schedule with occasional travel.

Qualifications

• High School Diploma or equivalent.
• Strong organizational skills and attention to detail.
• Proficiency with Microsoft Office Suite, including Excel, Word, and Outlook.
• Excellent written and verbal communication skills.

Responsibilities

• Assist with initial credentialing, recredentialing, enrollment, and revalidation applications for Medicare, Medicaid (including NY eMedNY), and commercial plans.
• Maintain accurate provider information within credentialing systems such as CAQH, PECOS, and NPPES.
• Track application status and proactively follow up with payers to ensure timely approvals.
• Verify and maintain provider licensure, board certifications, DEA registrations, malpractice coverage, education credentials, and other required documentation.
• Ensure timely provider revalidations in accordance with CMS and NYS Department of Health requirements.
• Maintain credentialing files in compliance with HRSA, FQHC, and audit standards.
• Collaborate with HR, Compliance, and Clinical Leadership on onboarding and termination processes.
• Monitor provider enrollment status to minimize disruptions in billing and reimbursement.
• Stay informed of Medicare, Medicaid, and commercial payer regulatory updates.
• Respond to credentialing and enrollment inquiries from internal and external stakeholders.
• Maintain HIPAA privacy and security standards.
• Assist with departmental reporting, audits, and special projects as needed.

Skills

Organizational skills

Attention to detail

Excellent communication

Education

High School Diploma

Associate degree

Tools

CAQH

PECOS

NPPES

Medicaid/eMedNY

Job description

CEC Healthcare, a not-for-profit Federally Qualified Health Center (FQHC), seeks a part-time Provider Enrollment Specialist in Bethpage, NY to support provider credentialing, enrollment, affiliation, and data management across Medicare, Medicaid NY eMedNY, and commercial plans.

You will ensure compliance with state/federal regulations and assist with onboarding, credentialing maintenance, and reimbursement readiness. Flexible day shift schedule with occasional travel.