Medicaid Provider Data Services Analyst-Work From Home

Medicaid Provider Data Services Analyst-Work From Home jobs at

Medicaid Provider Data Services Analyst-Work From Home

$ Not disclosed

The Medicaid NextGen - Provider Data Integration team is seeking dedicated individuals to support the data migration from QNXT to the Enterprise Provider Data Base (EPDB). This role will be essential to the successful integration of provider data to improve the quality and accuracy of provider records. This is an Entry Level position.

The Provider Data Analyst is responsible for the maintenance of the provider record (demographic and contractual) for all network and non-network providers and ensures that all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e., directory listings).

Role Responsibilities
  • Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data integrity issues.
  • Performs baseline demographic transaction updates in provider system applications in support of claim adjudication and Provider directory
  • Performs intake triage and responds to network inquiries, escalates when necessary.
  • Provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers.
  • Sends requests to individual providers and/or delegated groups to verify information on file and follows up as needed to ensure information is received.
  • Conducts audits of provider information and escalates issues for resolution as appropriate.
  • Communicates with health plan and PDS resources to resolve data issues required to make the provider record whole.

Required Qualifications
Demonstrated PC skills, including Microsoft Office products and internet navigation skills.

Strong Excel skills a plus.

Preferred Qualifications
Previous industry experience or claims processing preferred.

High School Diploma or G.E.D.

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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Published 2021-08-05

CVS Health looks for a Medicaid Provider Data Services Analyst-Work From Home in Arizona location.

How much Data Analyst Jobs professional earns at CVS Health?

The proposed salary for Data Analyst Jobs position at CVS Health is Not disclosed.

Medicaid Provider Data Services Analyst-Work From Home responsibilities at CVS Health

According to the common industry standard, Data Analyst Jobs specialist is in charge for the following activities.

Required Data Analyst Jobs qualifications at CVS Health

To be disscussed with candidate