Medicare Claims & PDE Analysis Specialist

CVS Health; Lincoln (NE); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Bonus potential

Comprehensive benefits

Job summary

CVS Health is seeking a detail-oriented analyst to review Medicare PDE errors, analyze rejections, and coordinate responses for internal/external clients. You will liaise across PDE teams, ensure CMS deadlines are met, and participate in weekly meetings to improve data accuracy.

Ideal candidates have a Bachelor’s or equivalent experience, strong communication, and proficiency in SQL/Python and Excel.

Qualifications

• Excellent written and verbal communication skills for client interaction and internal partners.
• Strong organizational abilities to manage multiple projects simultaneously.
• Excellent time management to meet time-sensitive requests.
• Proficiency with Microsoft Word and Excel required to analyze data.

Responsibilities

• Review claims and PDE errors; analyze and distribute PDE Rejections reports.
• Serve as liaison between PDE Reporting Team and other departments to resolve PDE rejections.
• Coordinate research with departments and submit responses to external clients per CMS deadlines.
• Assist with weekly PDE meetings and drive continuous improvement of Medicare claims data.

Skills

Excellent written and verbal comms

Strong organizational skills

Time management

Word and Excel proficiency

Education

Bachelor's degree preferred or equivalent work experience

Tools

SQL

Python

Job description

CVS Health is seeking a detail-oriented analyst to review Medicare PDE errors, analyze rejections, and coordinate responses for internal/external clients. You will liaise across PDE teams, ensure CMS deadlines are met, and participate in weekly meetings to improve data accuracy.

Ideal candidates have a Bachelor’s or equivalent experience, strong communication, and proficiency in SQL/Python and Excel.