Provider Enrollment Coordinator at CVS Health

Dallas, Texas, United States

CVS Health Logo
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

  • 3 years of experience in a centralized credentialing office and direct provider enrollment experience, such as credentialing or file maintenance (preferred), with experience in Word and Excel
  • Knowledge of health plan and governmental payer credentialing, enrollment, and requirements acquired through completion of a CPCS certification course, or sufficient job-related experience with intent to pursue certification
  • Knowledge of Microsoft Word and other PC applications, including preferred experience in a medical staff electronic database system (i.e., MD Staff)
  • Knowledge of PECOS and State Medicaid Enrollment applications
  • Knowledge of standards interpretation as related to NCQA
  • Preferred Qualifications
  • Previous experience with MD Staff and CAQH system

Responsibilities

  • Reviewing and processing credentialing applications and supporting documentation for the purpose of enrolling individual physicians and physician groups with payers
  • Accurate and timely processing of Part B provider enrollment applications

Skills

Key technologies and capabilities for this role

CredentialingProvider EnrollmentPECOSCAQHMD StaffMicrosoft WordMicrosoft ExcelCPCSNCQA

Questions & Answers

Common questions about this position

What is the pay range for the Provider Enrollment Coordinator role?

The typical pay range is $17.00 - $28.46 per hour. The actual base salary will depend on factors like experience, education, geography, and other relevant factors, and the position is eligible for a CVS Health bonus, commission, or short-term incentive program.

What benefits are offered for this position?

Benefits include affordable medical plan options, a 401(k) plan with matching company contributions, an employee stock purchase plan, no-cost wellness programs like screenings and counseling, and financial coaching.

Is this a remote position or does it require office work?

This information is not specified in the job description.

What skills and qualifications are required for this role?

Required qualifications include 3 years of experience in a centralized credentialing office and direct provider enrollment experience, knowledge of health plan and governmental payer credentialing (CPCS certification or equivalent), proficiency in Microsoft Word and Excel, knowledge of PECOS and State Medicaid Enrollment applications, and knowledge of standards interpretation as related to NCQA.

What is the company culture like at CVS Health?

CVS Health fosters a workplace where every colleague feels valued and belongs, with teams that reflect the customers, patients, and communities served, and emphasizes passion for transforming health care with heart.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters
1963Year Founded
DEBTCompany Stage
Healthcare, Consumer GoodsIndustries
10,001+Employees

Benefits

Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Disability Insurance
401(k) Retirement Plan
Company Equity
Wellness Program
Professional Development Budget
Paid Vacation
Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.
The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.
The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.
The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.
CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.
Increased consumer interest in wellness boosts demand for CVS's health-related products.
The trend towards value-based care aligns with CVS's integrated healthcare approach.

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