Credentialing Specialist

CVS Health Credentialing 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

Reviews analyzes, evaluates, validates provider/producer information against business/credentialing requirements and maintains information on Credentialing databases. Supports extensive research and analysis of sensitive provider/producer issues; addresses data integrity issues.

Job Description

• Assist with reviewing, analyzing, and validating provider/producer information to ensure it meets credentialing and business requirements
• Maintain and update provider/producer records in credentialing databases with a high level of accuracy
• Support research and review of provider/producer information, escalating sensitive or complex issues as needed
• Help identify and correct data discrepancies to support overall data integrity and compliance
• Handle confidential and sensitive information with professionalism, discretion, and care
• Organize and prioritize assigned tasks to meet deadlines in a fast-paced environment
• Draft and respond to basic professional correspondence, including emails and routine notices
• Communicate effectively with providers, internal staff, and management under guidance and supervision
• Work independently on routine tasks while seeking guidance for new or complex issues
• Use Microsoft Office applications (Word, Excel, Access) and internet resources to research and maintain information
• Demonstrate strong attention to detail and willingness to learn credentialing policies, procedures, and systems

Required Qualifications

• 1+ years customer service experience.
• 6+ months experience researching and analyzing data.
• 6+ months experience working with Microsoft Office applications (Word, Excel, Access) and internet resources.
• Able to work Franklin Hybrid work model, 3 days in office.

Preferred Qualifications

• Ability to work independently on routine tasks
• Ability to work reliably, prudently, and tactfully with confidential information.
• Ability to organize and prioritize work and manage multiple priorities.
• Excellent verbal and written communication skills including, letters, memos, and emails.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• Associate's degree preferred

Education

• High School diploma

Anticipated Weekly Hours 40

Time Type Full time

Pay Range $17.00 - $28.46

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.