Provider Data Services Specialist
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About The Position
At CVS Health, we are committed to bringing our heart to every moment of your health. This role is integral to maintaining the Provider Data, which includes both demographic and contractual information for all network and non-network providers. As a member of the Comet Engine PDS Team, you will ensure that all provider information is accurately recorded and maintained, which is essential for proper reimbursement and member access, including directory listings. Your responsibilities will include developing and maintaining standards for database integrity, implementing corrective actions, and managing communication processes with other departments to enhance database improvements. You will provide support for baseline provider data transactions that cannot be processed automatically due to system limitations or data integrity issues. This involves performing demographic transaction updates in provider system applications to support claim adjudication and the Provider directory. Additionally, you will be responsible for automating and manually loading, maintaining, and resolving all new and revised participating provider data transactions, ranging from basic to complex. You may also be tasked with loading third-party contracted reimbursement into applicable systems. Your role will require ongoing support in research and analysis to resolve concerns or issues raised by providers and other internal or external customers.
