Medicare Claims & PDE Data Analyst

CVS Health; Nevada; Hybrid; USD 47,000 - 112,000; Full time

Job summary

CVS Health in the United States seeks a Claims Analyst to review PDE errors, analyze PDE rejections, and distribute reports to internal and external clients. The role requires coordinating with the PDE Reporting Team and other departments to ensure timely resolutions and CMS compliance.

You will bring experience with government-regulated health programs, strong communication, and proficiency in Word, Excel, and SQL/Python.

Qualifications

• 3 years minimum experience with government-regulated health programs in financial operations or related experience.
• Excellent written and verbal communication skills for interaction with clients, internal partners, and government agencies.
• Proficiency with Microsoft Word and Excel.

Responsibilities

• Review claims and PDE errors and distribute PDE Rejections reports to internal and external clients.
• Coordinate research with various departments and submit responses to external clients or Acumen per CMS deadlines.
• Assist with weekly PDE meetings and improve Medicare claims data through root-cause analysis.

Skills

Communication

Time management

Organization

Multitasking

Education

Bachelor's degree preferred or equivalent work experience required

Tools

Microsoft Word

Microsoft Excel

SQL

Python

Job description

CVS Health in the United States seeks a Claims Analyst to review PDE errors, analyze PDE rejections, and distribute reports to internal and external clients. The role requires coordinating with the PDE Reporting Team and other departments to ensure timely resolutions and CMS compliance.

You will bring experience with government-regulated health programs, strong communication, and proficiency in Word, Excel, and SQL/Python.