Provider Data Service Specialist

CVS Health; United States; Remote; USD 55,000 - 75,000; Full time

Job summary

CVS Health is seeking a detail-oriented Provider Data Service Specialist to provide operational support and maintain accurate healthcare provider data in a fully remote role. The position focuses on managing provider information, supporting data transactions, improving data quality, and ensuring accurate information for members and internal systems.

You will collaborate with internal and external teams to maintain provider records, support network implementations, conduct audits, investigate

Qualifications

• 1+ year of experience maintaining information in multiple databases.
• Ability to manage multiple assignments and work effectively in a production environment.
• Proficiency in Microsoft Office applications.
• Strong Excel skills.
• Ability to prioritize tasks and manage multiple responsibilities in a fast-paced environment.
• Strong collaboration skills with internal and external teams.
• Excellent written and verbal communication skills.
• Experience with EPDB is preferred.

Responsibilities

• Maintain and update provider demographic and contract information, including complex and sensitive transactions.
• Perform data maintenance activities to support claims processing and provider directory accuracy.
• Collaborate with internal and external teams to implement new networks and complex contractual arrangements.
• Validate system enhancements and ensure data accuracy within operational processes.
• Identify, research, and conduct root cause analysis on provider data issues and trends.
• Perform audits of provider information and elevate issues for proper resolution.
• Recommend process improvements to enhance data quality and operational efficiency.

Skills

Attention to detail

Data management

Multitasking

Communication skills

Team collaboration

Tools

Microsoft Excel

Microsoft Office

Job description

CVS Health is seeking a detail-oriented Provider Data Service Specialist to provide operational support and maintain accurate healthcare provider data. This fully remote role focuses on managing provider information, supporting data transactions, improving data quality, and ensuring accurate information for healthcare members and internal systems.

The successful candidate will work with internal and external teams to maintain provider records, support network implementations, conduct audits, investigate data issues, and recommend process improvements. This position is ideal for someone with strong organizational skills, database experience, and the ability to manage multiple priorities in a fast-paced healthcare environment.

Key Responsibilities

• Maintain and update provider demographic and contract information, including complex and sensitive transactions.
• Perform data maintenance activities to support claims processing and provider directory accuracy.
• Collaborate with internal and external teams to implement new networks and complex contractual arrangements.
• Validate system enhancements and ensure data accuracy within operational processes.
• Identify, research, and conduct root cause analysis on provider data issues and trends.
• Perform audits of provider information and elevate issues for proper resolution.
• Recommend process improvements to enhance data quality and operational efficiency.

Requirements

• 1+ year of experience maintaining information within multiple databases.
• Ability to manage multiple assignments and work effectively in a production environment.
• Proficiency in Microsoft Office applications.
• Strong Excel skills.
• Ability to prioritize tasks and manage multiple responsibilities in a fast-paced environment.
• Strong collaboration skills with internal and external teams.
• Excellent written and verbal communication skills.
• Experience with EPDB is preferred.

Strong knowledge of:

• Database management, data maintenance, and information accuracy.
• Microsoft Excel, reporting, and healthcare data processes.
• Data auditing, issue investigation, and process improvement.