Credentialing Specialist

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.
• 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.

Preferred Qualifications:

• Ability to work independently on routine tasks
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• College degree or equivalent work experience

Education High School Diploma/Associate's degree preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$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.

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.