Provider Data Support 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 Support team ensures accurate, timely processing of claims by validating provider information, maintaining TIN/NPI and W9 data, updating provider records, reviewing UB04 and CMS1500 claim submissions, processing overpayments and posting payments as needed, and collaborating with internal partners and external stakeholders to support timely claim adjudication. Key Responsibilities Review and interpret UB‑04 and CMS‑1500 claim forms. Evaluate claims for accuracy, completeness, and correct billing practices. Validate provider information (TIN, NPI, addresses/locations) against internal systems and W‑9 documentation. Maintain and update provider data within claims and provider databases. Support accuracy and timely payment by preventing and correcting data mismatches. Ensure integrity of provider tax information and master data. Process overpayment requests sent from third party vendors and post payments as needed. Collaborate with cross‑functional teams to resolve discrepancies and support timely claim processing. Communicate with providers and policyholders to obtain missing information and clarify claim details. Required Qualifications 1+ years medical claim processing experience Experience in a production environment Demonstrated ability to handle multiple assignments competently, accurately, and efficiently Effective communications, organizational, and interpersonal skills Preferred Qualifications Associate degree preferred Education High School diploma or GED Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $18.50 - $35.29 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. 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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.