Provider Data Services Specialist, CVS Health

Provider Data Services Specialist

CVS Health

Location:
United States, Arizona

Category:
-

Contract Type:
Employment contract

Salary:

17.00 - 28.46 USD / Hour

Save Job

Apply Position

Job Description:

The Provider Data Services Specialist compares and contrasts the provider system with network data and regulatory sources, in order to ensure accuracy of data feeds to various applications. This person manages provider records to ensure the provider directory is accurate for members, as well as that records are set up appropriately for claims processing. This role involves working in a fast-paced environment with several colleagues serving various functions.

Job Responsibility:

review and submit requests to update the provider module (within the QNXT system) for adds/changes related to Mercy Care Plan
based on information from new contracts, expansion efforts, and routine provider changes, research the requests for updates to ensure they meet CMS (Centers for Medicare & Medicaid Services) and AHCCCS (Arizona Health Care Cost Containment System) regulations for member utilization
utilize standard data elements for provider data to feed member directories, claim adjudication, encounter submissions, and regulatory utilization reports

Requirements:

1-2 years of experience in customer service
must reside in Arizona

Nice to have:

demonstrated ability to handle multiple assignments competently, accurately, and efficiently
strong analytical and written/oral communication skills
1-2 years of experience with SQL
1-2 years of experience in Microsoft Excel
previous experience working with QNXT
previous experience with medical claims processing
previous knowledge of medical billing

What we offer:

affordable medical plan options
401(k) plan (including matching company contributions)
employee stock purchase plan
no-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
paid time off
flexible work schedules
family leave
dependent care resources
colleague assistance programs
tuition assistance
retiree medical access

Additional Information:

Job Posted:
September 28, 2025

Expiration:
October 06, 2025

Employment Type:

Fulltime

Work Type:

Remote work

View All Jobs In This Company

Job Link Share:

Welcome to CrawlJobs.com –
Your Global Job Discovery Platform

At CrawlJobs.com, we simplify finding your next career opportunity by bringing job listings directly to you from all corners of the web. Using cutting-edge AI and web-crawling technologies, we gather and curate job offers from various sources across the globe, ensuring you have access to the most up-to-date job listings in one place.