Medicare PDE & Claims Analyst

CVS Health; Hartford (CT); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Job summary

CVS Health is seeking a detail-oriented claims analyst to review PDE errors and drive timely resolution. You will analyze PDE Rejections, coordinate with the PDE Reporting Team and CMS guidance, and support weekly meetings to improve Medicare claims data accuracy.

The role requires a background in government-regulated health programs, strong communication, and the ability to manage multiple projects with accuracy. A Bachelor’s degree is preferred or equivalent experience.

Qualifications

• 3 years minimum experience with government-regulated health programs within financial operations and/or related experience (Medicaid, Medicare, and/or Exchanges).
• 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 in time-sensitive requests.

Responsibilities

• 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 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 communication

Organization

Time management

Education

Bachelor’s degree preferred or equivalent

Tools

Microsoft Word

Excel

SQL

Python

Job description

CVS Health is seeking a detail-oriented claims analyst to review PDE errors and drive timely resolution. You will analyze PDE Rejections, coordinate with the PDE Reporting Team and CMS guidance, and support weekly meetings to improve Medicare claims data accuracy.

The role requires a background in government-regulated health programs, strong communication, and the ability to manage multiple projects with accuracy. A Bachelor’s degree is preferred or equivalent experience.