Medicare Claims Data Analyst — PDE Reconciliation & Insights

CVS Health; Alabama; Hybrid; USD 47.000 - 112.000; Vollzeit

Benefits dieser Stelle

Medical/Dental/Vision

401(k) with company match

Paid time off

Zusammenfassung

CVS Health is seeking a claims analyst to review PDE (Prescription Drug Event) errors and coordinate resolution across internal teams and external clients. The role requires experience with government-regulated health programs and CMS guidance, with emphasis on data accuracy and timely responses.

The position supports Medicare/Part D operations, involves collaboration with the PDE Reporting Team, and offers a comprehensive benefits package. Full-time role with competitive pay.

Qualifikationen

• 3 years minimum experience with government-regulated health programs within financial operations.
• Bachelor's degree preferred or equivalent work experience required.
• Experience with Medicare/Medicaid/Exchanges is advantageous.

Aufgaben

• Review claims and PDE (Prescription Drug Event) errors.
• Analyze and distribute PDE Rejections reports to clients.
• Coordinate research with PDE teams and respond to external clients per CMS deadlines.
• Assist with weekly PDE meetings and ensure timely resolution of rejections.
• Perform root cause analysis to improve Medicare claims data and recommend system/process enhancements.

Kenntnisse

Communication

Organization

Time management

Project management

Ausbildung

Bachelor's degree or equivalent

Tools

Microsoft Word

Excel

SQL

Python

Jobbeschreibung

CVS Health is seeking a claims analyst to review PDE (Prescription Drug Event) errors and coordinate resolution across internal teams and external clients. The role requires experience with government-regulated health programs and CMS guidance, with emphasis on data accuracy and timely responses.

The position supports Medicare/Part D operations, involves collaboration with the PDE Reporting Team, and offers a comprehensive benefits package. Full-time role with competitive pay.