Medicare PDE & Claims Analytics Specialist

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

Benefits dieser Stelle

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Zusammenfassung

CVS Health in Minnesota is seeking a claims/PDE analyst to review PDE errors, analyze rejections, and serve as liaison among reporting, eligibility, and reconciliation teams. You will coordinate with multiple departments to meet CMS deadlines and improve data accuracy.

The role requires 3 years in government-regulated health programs, strong communication, and proficiency in SQL/Python, Excel, and Word. Full-time with comprehensive benefits and bonus eligibility.

Qualifikationen

• 3 years minimum experience with government-regulated health programs within financial operations.
• Excellent written and verbal communication with clients and partners.
• Proficiency with Microsoft Word and Excel.
• Proficiency with SQL and Python.

Aufgaben

• Review claims and PDE errors and analyze PDE rejections.
• Coordinate research with departments and respond to external clients.
• Serve as liaison between PDE Reporting Team and PDE Eligibility/Reconciliation.
• Assist with weekly PDE meetings and CMS deadlines.
• Improve Medicare claims data through root-cause analysis and recommendations.

Kenntnisse

Communication

Organizational skills

Time management

Ausbildung

Bachelor's degree preferred or equivalent work experience

Tools

SQL

Python

Microsoft Excel

Microsoft Word

Jobbeschreibung

CVS Health in Minnesota is seeking a claims/PDE analyst to review PDE errors, analyze rejections, and serve as liaison among reporting, eligibility, and reconciliation teams. You will coordinate with multiple departments to meet CMS deadlines and improve data accuracy.

The role requires 3 years in government-regulated health programs, strong communication, and proficiency in SQL/Python, Excel, and Word. Full-time with comprehensive benefits and bonus eligibility.