(Remote Work) Provider Data Services Specialist – CVS Health

Job Overview

• Job Title Provider Data Services Specialist
• Hiring Organization CVS Health
• Company Website https://www.cvshealth.com/
• Remote Locations United States
• Job Type Remote, Full-Time

Business Overview

Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Pay Range

The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.16

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Job Responsibilities

This position can be Work From Anywhere in the United States. Must be willing to work EST hours.

• Maintains the Provider Data (demographic and contractual) for all network and non-network providers.
• Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e., directory listings).
• Develops and maintains standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements.
• Performs baseline demographic transaction updates in provider system applications in support of claim adjudication and Provider directory
• Performs intake triage and responds to network inquiries, escalates when necessary.
• Provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers.
• Sends requests to individual providers and/or delegated groups to verify information on file and follows up as needed to ensure information is received.
• Conducts audits of provider information and escalates issues for resolution as appropriate.

Job Requirements

Required Qualifications

• Demonstrated PC skills, including Microsoft Office products and internet navigation skills.
• 6 months of healthcare/claims experience.
• 6 months of customer service experience.

Preferred Qualifications

• Previous industry experience or claims processing preferred
• Strong Excel skills a plus.
• EPDB/SCM Experience
• Knowledge of Provider Data setup

Education

• High School Diploma/GED

How To Apply

Click “Apply” below to fill in the application form!