Senior Claim Data Specialist (Provider Claims Operations) - Remote Florida - CVS : Job Details

Claims analysis related to disputes, legal matters, state complaints, provider inquiries, and internal team inquires. In order to determine if there are any claim payment or denial issues that may affect Utilization Management, Enrollment, Claims, Configuration, Network, Contracting and/or Provider Data. If any issues are identified you will submit the necessary documents to specific areas to ensure all is updated and corrected. Submitting all projects and/or claims to be reprocessed in order to ensure provider contract is implemented effectively and avoid any further ongoing issues. Provider, internal and external education when required. Attending provider group meetings as well as individual meetings internally and/or externally. Submitting projects within Excel. Required Qualifications:Must reside in Florida .-3 years of provider claims experience .-3 years of intermediate Excel experience with proficiency in formulas. Preferred Qualifications:Certified Professional Coder (CPC). Pr...Data Specialist, Operations, Claims, Specialist, Remote, Senior, Technology, Retail