Medicare Claims Data Analyst - PDE Rejections & Insights

CVS Health; Kansas City (MO); Presencial; USD 47.000 - 112.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Descripción de la vacante

CVS Health in Kansas City, MO is seeking a full-time Claims Analyst to review claims and PDE (Prescription Drug Event) errors. You will analyze PDE rejections, coordinate research across departments, and respond to external clients per CMS deadlines.

Ideal candidates have 3+ years in government-regulated health programs, strong Excel/Word skills, and experience with SQL or Python. This role offers a comprehensive benefits package and career growth opportunities at CVS Health.

Formación

• 3 years minimum experience with government-regulated health programs within financial operations and/or related experience.
• Excellent written and verbal communication skills for interaction with clients, internal partners, and government agencies.
• Strong organizational skills and ability to manage multiple projects simultaneously.
• Excellent time management skills as these requests are time sensitive.
• Proficiency with Microsoft Word and Excel.
• Proficiency with SQL and/or Python.

Responsabilidades

• Review claims and PDE errors and analyze PDE Rejections reports.
• Serve as liaison between PDE Reporting Team, PDE Eligibility/Reconciliation, and related entities.
• Coordinate research with various departments and respond to external clients per CMS deadlines.
• Assist with weekly PDE meetings and drive continuous improvement through root cause analysis.

Conocimientos

PDE/Claims analysis

CMS guidance

SQL

Python

Excel

Communication

Educación

Bachelor's degree or equivalent

Herramientas

Microsoft Word

Excel

SQL

Python

Descripción del empleo

CVS Health in Kansas City, MO is seeking a full-time Claims Analyst to review claims and PDE (Prescription Drug Event) errors. You will analyze PDE rejections, coordinate research across departments, and respond to external clients per CMS deadlines.

Ideal candidates have 3+ years in government-regulated health programs, strong Excel/Word skills, and experience with SQL or Python. This role offers a comprehensive benefits package and career growth opportunities at CVS Health.