Medicare Claims Data Analyst - PDE Rejections

CVS Health; Iowa Center (IA); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a detail-oriented professional to review claims and PDE errors, acting as a liaison across PDE teams and external clients. You will analyze PDE data, coordinate with multiple departments, and ensure timely resolutions according to CMS deadlines.

Preferred candidates have ~3 years in government-regulated health programs and strong SQL/Python proficiency, with a Bachelor's degree or equivalent experience. This is a full-time role in the US with competitive benefits.

Qualifications

• Minimum ~3 years experience with government health programs in financial operations or related area.
• Experience with Medicaid, Medicare, or Exchanges preferred.
• Bachelor's degree preferred or equivalent work experience.

Responsibilities

• Review claims and PDE (Prescription Drug Event) errors.
• Analyze and distribute PDE Rejections reports to internal and external clients.
• Coordinate research with departments and meet CMS deadlines.
• Assist weekly PDE meetings and drive continuous improvement of Medicare claims data.

Skills

Communication skills

Organizational skills

Time management

Microsoft Word

Excel

SQL

Python

Education

Bachelor's degree or equivalent

Tools

SQL

Python

Microsoft Word

Excel

Job description

CVS Health is seeking a detail-oriented professional to review claims and PDE errors, acting as a liaison across PDE teams and external clients. You will analyze PDE data, coordinate with multiple departments, and ensure timely resolutions according to CMS deadlines.

Preferred candidates have ~3 years in government-regulated health programs and strong SQL/Python proficiency, with a Bachelor's degree or equivalent experience. This is a full-time role in the US with competitive benefits.