Provider Data Services Senior Coordinator (Fully Remote) at CVS Health in Boise, Idaho, United States 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 commitmentto 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.
Position Summary + Maintains the Provider Data (demographic and contractual) for roster review configuration and loading.
• 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.
• Extract information from provider systems to meet business reporting needs.
Required Qualifications + 3+ years of experience and knowledge of Provider Data Services systems and other end user applications.
• 1-3 years' Network background.
• Advanced Microsoft Excel skills including knowledge of formulas and VLOOKUPs.
• 1+ years' QNXT experience.
• SQL experience Preferred Qualifications + QuickBase experie To view full details and how to apply, please login or create a Job Seeker account
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