Medicare PDE Claims Analyst: Data & Compliance

CVS Health; Connecticut; Hybrid; USD 47.000 - 112.000; Vollzeit

Benefits dieser Stelle

Medical insurance

Dental and Vision coverage

Paid time off

Retirement savings options

Wellness programs

Zusammenfassung

CVS Health is seeking a detail-oriented professional to review PDE errors and coordinate resolutions with internal teams and external clients. The role involves analyzing PDE rejections, coordinating research with multiple departments, and ensuring CMS deadlines are met.

Ideal candidates will have knowledge of Part D plans and CMS guidance, with strong communication and organizational skills to handle time-sensitive requests and contribute to process improvements.

Qualifikationen

• Bachelor's degree or equivalent work experience required.
• Experience with government-regulated health programs preferred.
• Strong communication and organizational skills; able to manage multiple tasks.

Aufgaben

• Review claims and PDE errors; analyze and distribute PDE Rejections reports.
• Serve as liaison between the PDE Reporting Team and other entities involved with PDE.
• Coordinate research with departments and respond to external clients or CMS deadlines.
• Assist with weekly PDE meetings and drive continuous improvement of Medicare data.
• Apply CMS guidance and ensure compliance in PDE processes.

Kenntnisse

Communication

Organization

Time management

Attention to detail

Problem solving

Ausbildung

Bachelor's degree or equivalent

Tools

SQL

Python

Microsoft Word

Excel

Jobbeschreibung

CVS Health is seeking a detail-oriented professional to review PDE errors and coordinate resolutions with internal teams and external clients. The role involves analyzing PDE rejections, coordinating research with multiple departments, and ensuring CMS deadlines are met.

Ideal candidates will have knowledge of Part D plans and CMS guidance, with strong communication and organizational skills to handle time-sensitive requests and contribute to process improvements.