Provider Data Service Specialist - Fully Remote
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.
Work from home position
Position Summary
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.
Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data integrity issues.
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.
Required Qualifications
6 months of healthcare experience (medical office experience, Medical billing/coding, and Data entry)
Must be proficient in excel
Demonstrated PC skills, including Microsoft Office products and internet navigation skills.
Preferred Qualifications
Exposure to EPDB or PRMS is a plus
Communication skills
Ability to conduct research activities
Education
High School Diploma or GED
Pay Range
The Typical Pay Range For This Role Is
$17.00 - $28.46
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Companys 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 02/19/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Apply Now
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.
Work from home position
Position Summary
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.
Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data integrity issues.
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.
Required Qualifications
6 months of healthcare experience (medical office experience, Medical billing/coding, and Data entry)
Must be proficient in excel
Demonstrated PC skills, including Microsoft Office products and internet navigation skills.
Preferred Qualifications
Exposure to EPDB or PRMS is a plus
Communication skills
Ability to conduct research activities
Education
High School Diploma or GED
Pay Range
The Typical Pay Range For This Role Is
$17.00 - $28.46
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Companys 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 02/19/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Apply Now