Provider Data Specialist

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 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. In This Role, You Will 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. Required Qualifications 1-2 years of experience in customer service. Must reside in Arizona. Preferred Qualifications 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. Education High school diploma or GED. Anticipated Weekly Hours 40 Time Type Full time Pay Range $17.00 - $28.46 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. 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. We anticipate the application window for this opening will close on: 07/28/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr