Remote Provider Data Specialist for Directory & Compliance

CVS Health; United States; On-site; USD 23,000 - 39,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking a Provider Data Specialist to maintain provider demographic and contractual information, ensuring accurate records for reimbursement and member access. The role supports directory integrity and collaborates with multiple departments.

The position is full-time with work-from-home in TX or hybrid arrangements, offering a 40-hour work week and a comprehensive benefits package. CVS Health bonuses are available in addition to base pay.

Qualifications

• Proficiency with Microsoft Office and internet navigation.
• 6 months of healthcare experience.

Responsibilities

• Maintains the Provider Data (demographic and contractual) for all network and non-network providers.
• 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.

Skills

Microsoft Office

Internet navigation

Healthcare experience

Education

High School

Job description

CVS Health is seeking a Provider Data Specialist to maintain provider demographic and contractual information, ensuring accurate records for reimbursement and member access. The role supports directory integrity and collaborates with multiple departments.

The position is full-time with work-from-home in TX or hybrid arrangements, offering a 40-hour work week and a comprehensive benefits package. CVS Health bonuses are available in addition to base pay.