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Provider Data Services Specialist - Fully Remote

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About the position

As a Provider Data Services Specialist at Aetna, Inc., you will play a crucial role in ensuring the accuracy and efficiency of provider data management. Your primary responsibility will be to identify, research, and resolve issues related to National Provider Identifier (NPI) data, which is essential for prompt claim payments and matching logic. This will involve making calls to provider offices to gather necessary information and clarify any discrepancies. You will collaborate closely with your team and internal counterparts to ensure that NPI data is accurately loaded into the system for all provider types, which is vital for maintaining the integrity of our healthcare services. In this position, you will need to manage constantly changing priorities and work independently to assess and evaluate provider data across various systems and NPI types. Your analytical skills will be put to the test as you navigate through complex data sets and ensure that all information is up-to-date and compliant with industry standards. This role is fully remote, allowing you to contribute to our mission of delivering enhanced human-centric healthcare from the comfort of your own home. At CVS Health, we are committed to fostering a culture of innovation and transformation. Your contributions will directly impact our ability to provide personal, convenient, and affordable healthcare solutions. We value the heart at the center of our operations, and we want you to feel empowered in your role as you help us achieve our goals.

Responsibilities

  • Identify, research, and resolve issues related to NPI data to ensure prompt claim payment and matching logic.
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  • Make calls to provider offices to gather necessary information and clarify discrepancies.
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  • Collaborate with team members and internal counterparts to ensure accurate loading of NPI data in the system for all provider types.
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  • Manage constantly changing priorities and work independently to assess and evaluate provider data across systems and NPI types.

Requirements

  • 1-2 years of experience in Provider Data Maintenance.
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  • Excellent communication skills, both written and oral.
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  • Strong analytical skills.
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  • Proficiency in Microsoft Office applications, particularly Excel.
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  • Understanding of provider data, including NPI, Tax ID, provider specialty, and demographic information.

Nice-to-haves

  • Previous experience in a production environment.
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  • Familiarity with EWMP, EPDB, CAQH, and NPPES.

Benefits

  • Full range of medical, dental, and vision benefits.
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  • 401(k) retirement savings plan.
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  • Employee Stock Purchase Plan for eligible employees.
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  • Fully-paid term life insurance plan for eligible employees.
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  • Short-term and long-term disability benefits.
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  • Numerous well-being programs.
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  • Education assistance and free development courses.
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  • CVS store discount and discount programs with participating partners.
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  • Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the year.
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