Medicare PDE & Claims Analyst

CVS Health; Minneota (MN); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a detail-oriented analyst to review claims and PDE errors, coordinate research with multiple teams, and ensure timely CMS-compliant responses. The role supports continuous improvement of Medicare data through root-cause analysis and collaborative problem solving.

Ideal candidates have ~3 years in government-regulated health programs, strong Excel/SQL skills, and excellent communication.

Qualifications

• ~3 years minimum experience with government-regulated health programs within financial operations and/or related experience (Medicaid, Medicare, and/or Exchanges).
• Familiarity with CMS guidance and Part D plans preferred.
• Strong written and verbal communication with clients and internal teams.

Responsibilities

• Review claims and PDE errors and distribute PDE Rejections reports.
• Coordinate research with departments and respond to external clients per CMS deadlines.
• Assist with weekly PDE meetings and improve Medicare claims data through root-cause analysis.
• Ensure compliance with CMS guidance and drive process improvements.

Skills

Communication skills

Organizational skills

Time management

SQL

Python

Excel

Education

Bachelor's degree or equivalent

Tools

SQL

Python

Excel

Word

Job description

CVS Health is seeking a detail-oriented analyst to review claims and PDE errors, coordinate research with multiple teams, and ensure timely CMS-compliant responses. The role supports continuous improvement of Medicare data through root-cause analysis and collaborative problem solving.

Ideal candidates have ~3 years in government-regulated health programs, strong Excel/SQL skills, and excellent communication.