Provider Enrollment 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

Provider Enrollment Specialist (Part-Time)

Location

Bethpage, NY (with occasional travel to Glen Cove and Seaford clinic locations)

Organization

CEC Healthcare

Job Type

Part-Time – 20 hours

Schedule

Flexible part-time hours (day shift)

Compensation

$25.00–$30.00 per hour, commensurate with experience and qualifications.

About Us

CEC Healthcare, a not-for-profit Federally Qualified Health Center (FQHC), is dedicated to providing high-quality, compassionate, and accessible healthcare services to the communities we serve. Our mission-driven team supports patients across multiple locations while promoting health equity and improving community wellness.

Position Summary

The Provider Enrollment Specialist supports provider credentialing, enrollment, affiliation, and provider data management processes. This role ensures compliance with federal and state regulations, payer requirements, and FQHC standards while supporting provider onboarding, credentialing maintenance, and reimbursement readiness.

Key Responsibilities

• Assist with initial credentialing, recredentialing, enrollment, and revalidation applications for Medicare, Medicaid (including NY eMedNY), and commercial insurance 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 New York State Department of Health requirements.
• Maintain credentialing files in compliance with HRSA, FQHC, and audit standards.
• Collaborate with Human Resources, Compliance, and Clinical Leadership on provider onboarding and termination processes.
• Monitor provider enrollment status to minimize disruptions in billing and reimbursement.
• Support payer roster updates and enrollment changes.
• Stay informed of Medicare, Medicaid, and commercial payer regulatory updates.
• Respond to credentialing and enrollment inquiries from internal and external stakeholders.
• Maintain compliance with HIPAA privacy and security standards.
• Assist with departmental reporting, audits, and special projects as needed.

Qualifications

Required

• 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.

Preferred

• Associate degree.
• At least one year of experience in provider enrollment, credentialing, medical staff services, healthcare administration, or a related field.
• Experience with Medicare and Medicaid enrollment processes, particularly New York State Medicaid/eMedNY.
• Familiarity with CAQH, PECOS, NPPES, and healthcare credentialing platforms.
• Knowledge of CMS, HRSA, and FQHC operational guidelines.

Skills & Competencies

• Ability to manage multiple priorities and meet deadlines.
• Strong analytical and problem-solving abilities.
• Ability to maintain confidentiality and handle sensitive information with discretion.
• Self-motivated with the ability to work independently and collaboratively.

Why Join CEC Healthcare?

• Opportunity to make a meaningful impact within a mission-driven, community-focused organization.
• Collaborative and supportive work environment.
• Work with dedicated healthcare professionals committed to improving community health.
• Contribute to the success of a respected not-for-profit Federally Qualified Health Center.

Work Location

Primary work location is Bethpage, NY, with occasional travel to Glen Cove and Seaford clinic locations.

CEC Healthcare is an Equal Opportunity Employer and values diversity in its workforce.