Provider Data Services Specialist

Provider Data Services Specialist at CVS Health in Boise, Idaho, United States Job Description 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 commitment to 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 Provider Data Specialist compare and contrast the provider system with network data and regulatory sources to ensure data feeds to various applications are accurate. The Provider Data Analyst manages our provider records to ensure the provider directory is accurate for our members, and that records are set up appropriately for claims processing. + Review and submit requests to update the provider module within the QNXT system for adds/changes related to Mercy Care Plan. + This is a fast paced environment with great team diversity. + Based on information from new contracts, expansion efforts, and routine provider changes, research the requests for updates to ensure they meet CMS and AHCCCS regulations for member utilization. + Standard data elements for provider data is used to feed member directories, claim adjudication, encounter submissions, and regulatory utilization reports. Required Qualifications + Demonstrated ability to handle multiple assignments competently, accurately and efficiently. + Strong analytical and written/oral communication skills. + 1-2 years of customer service experience. Preferred Qualifications + MS SQL Experience - Basic (1-2 Years). + Excel Experience - Intermediate (1-2 Years). + Hands on experience working with QNXT. + Medical Claims Processing. + Medical Billing Knowledge. Education + High School Diploma or GED Pay Range The typical pay range for this role is: $17.00 - $25.65 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 elig To view full details and how to apply, please login or create a Job Seeker account