Medicare PDE & Claims Analytics Specialist

CVS Health; Baton Rouge (LA); Presencial; USD 47.000 - 112.000; Jornada completa

Descripción de la vacante

CVS Health is seeking a dedicated professional to review claims and PDE errors, serving as a liaison among PDE Reporting Team, PDE Eligibility/Reconciliation, and external clients to ensure timely resolutions. You will analyze rejections, coordinate with multiple departments, and help meet CMS deadlines.

The role requires a background in government-regulated health programs, strong communication, and the ability to manage multiple projects.

Formación

• 3 years minimum experience with government-regulated health programs within financial operations.
• Excellent written and verbal communication with clients and partners.
• Strong organizational skills and ability to manage multiple projects simultaneously.
• Proficiency with Microsoft Word and Excel.
• Proficiency with SQL and/or Python.
• Bachelor's degree preferred or equivalent work experience.

Responsabilidades

• Review claims and PDE errors and analyze PDE rejections.
• Distribute PDE Rejections reports to clients and internal teams.
• Coordinate research with departments and respond to external clients per CMS deadlines.
• Assist with the weekly PDE meetings and CMS guidance reviews.
• Identify root causes and propose system/process improvements.

Conocimientos

Communication

Time management

Organization

Attention to detail

Deadline-driven

Educación

Bachelor's degree preferred or equivalent

Herramientas

Microsoft Word

Microsoft Excel

SQL

Python

Descripción del empleo

CVS Health is seeking a dedicated professional to review claims and PDE errors, serving as a liaison among PDE Reporting Team, PDE Eligibility/Reconciliation, and external clients to ensure timely resolutions. You will analyze rejections, coordinate with multiple departments, and help meet CMS deadlines.

The role requires a background in government-regulated health programs, strong communication, and the ability to manage multiple projects.