Our Ability Jobs

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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.

• Conducts audits of provider information and escalates issues for resolution as appropriate.

• Automates and manually loads, maintains, and resolves all new and revised participating provider data transactions (basic to complex).

• May also load third party contracted reimbursement into applicable systems. Required Qualifications

• 1-3 years' of Provider Data Services background.

• 1-3 years' Network background.

• 1+ years' QNXT experience.

• Demonstrated ability to handle multiple assignments. Preferred Qualifications

• Advanced Microsoft Excel skills

• Strong written and verbal communication skills. Education

• High school diploma or GED

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

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 Company’s 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 jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 05/15/2024

We are an equal opportunity and affirmative action employer. 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.