Provider Data Support Specialist

CVS Health • Franklin, TN

1d • $19 - $35

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 The Provider Data Support team ensures accurate, timely processing of claims by validating provider information, maintaining TIN/NPI and W9 data, updating provider records, reviewing UB04 and CMS1500 claim submissions, processing overpayments and posting payments as needed, and collaborating with internal partners and external stakeholders to support timely claim adjudication.

Requirements

• 1+ years medical claim processing experience
• Experience in a production environment
• Demonstrated ability to handle multiple assignments competently, accurately, and efficiently
• Effective communications, organizational, and interpersonal skills
• High School diploma or GED

Nice To Haves

• Associate degree preferred

Responsibilities

• Review and interpret UB‑04 and CMS‑1500 claim forms.
• Evaluate claims for accuracy, completeness, and correct billing practices.
• Validate provider information (TIN, NPI, addresses/locations) against internal systems and W‑9 documentation.
• Maintain and update provider data within claims and provider databases.
• Support accuracy and timely payment by preventing and correcting data mismatches.
• Ensure integrity of provider tax information and master data.
• Process overpayment requests sent from third party vendors and post payments as needed.
• Collaborate with cross‑functional teams to resolve discrepancies and support timely claim processing.
• Communicate with providers and policyholders to obtain missing information and clarify claim details.

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