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CVS Health Provider Data Services, Analyst in Pennsylvania

Job Description

  • 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

  • Demonstrated PC skills, including Microsoft Office products and internet navigation skills. - Strong Excel skills a plus.- Previous industry experience or claims processing preferred.

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.

  • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications

  • Access, SQL, QuickBase experience

Education

High School Diploma or G.E.D.

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.

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