Credentialing Specialist

CVS Health • Franklin, TN

1d • $17 - $28

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: Reviews analyzes, evaluates, validates provider/producer information against business/credentialing requirements and maintains information on Credentialing databases. Supports extensive research and analysis of sensitive provider/producer issues; addresses data integrity issues. Job Description Assist with reviewing, analyzing, and validating provider/producer information to ensure it meets credentialing and business requirements Maintain and update provider/producer records in credentialing databases with a high level of accuracy Support research and review of provider/producer information, escalating sensitive or complex issues as needed Help identify and correct data discrepancies to support overall data integrity and compliance Handle confidential and sensitive information with professionalism, discretion, and care Organize and prioritize assigned tasks to meet deadlines in a fast-paced environment Draft and respond to basic professional correspondence, including emails and routine notices Communicate effectively with providers, internal staff, and management under guidance and supervision Work independently on routine tasks while seeking guidance for new or complex issues Use Microsoft Office applications (Word, Excel, Access) and internet resources to research and maintain information Demonstrate strong attention to detail and willingness to learn credentialing policies, procedures, and systems

Requirements

• 6+ months experience researching and analyzing data.
• 6+ months experience working with Microsoft Office applications (Word, Excel, Access) and internet resources.
• Ability to work reliably, prudently, and tactfully with confidential information.
• Ability to organize and prioritize work and manage multiple priorities.
• Excellent verbal and written communication skills including, letters, memos, and emails.
• Excellent attention to detail.
• Ability to work independently with minimal supervision.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.

Responsibilities

• Assist with reviewing, analyzing, and validating provider/producer information to ensure it meets credentialing and business requirements
• Maintain and update provider/producer records in credentialing databases with a high level of accuracy
• Support research and review of provider/producer information, escalating sensitive or complex issues as needed
• Help identify and correct data discrepancies to support overall data integrity and compliance
• Handle confidential and sensitive information with professionalism, discretion, and care
• Organize and prioritize assigned tasks to meet deadlines in a fast-paced environment
• Draft and respond to basic professional correspondence, including emails and routine notices
• Communicate effectively with providers, internal staff, and management under guidance and supervision
• Work independently on routine tasks while seeking guidance for new or complex issues
• Use Microsoft Office applications (Word, Excel, Access) and internet resources to research and maintain information
• Demonstrate strong attention to detail and willingness to learn credentialing policies, procedures, and systems

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees