Provider Data Service Specialist - Fully Remote
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At a glance
Requirements
Credentials this posting asks for.
Job overview
CVS Health seeks a Provider Data Service Specialist to provide operational support, maintain and clean provider data, and ensure quality information for claims adjudication. The role involves collaborating across departments, leading technical initiatives, performing system validation, and conducting audits to improve processes, all within a fully remote, full‑time environment.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
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
Provides operational support and performs data maintenance and clean-up for data transactions (basic to complex). In addition, performs data transactions and maintenance associated with projects, expansions, and new product implementations. Works with other departments to ensure quality provider data to our members.
Additional Duties
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Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems in support of claims adjudication and provider directory.
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Works collaboratively with internal/external constituents to implement new networks and complex contractual arrangements.
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May provide technical and/or functional leadership within unit (i.e., team lead).
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Performs validation of system enhancements.
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Identifies, researches and conducts root cause analyses (e.g. problem providers identified by PST, trends from routine PDS audits) and collaborates cross-functionally within the organization to recommend process improvements.
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Conducts and manages audits of provider information and escalates issues for resolution as appropriate.
Required Qualifications
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1+ years of maintaining information within multiple database.
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1-2 Years + of Provider data service background.
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Demonstrated ability to handle multiple assignments.
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Demonstrated Ability to work in a production environment
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Proficient in Microsoft Office Applications with Advanced skills in Excel.
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Demonstrated success prioritizing work and the ability to multi-task in a fast paced environment.
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Demonstrated success in collaborating with others to meet/exceed expectations.
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Experience providing clear and concise written and verbal communications
Preferred Qualifications
- EPDB experience
Education
- Associate's degree or equivalent work experience.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$17.00 - $31.30
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 eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .
We anticipate the application window for this opening will close on: 08/23/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.
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