Medicare PDE & Claims Data Analyst

CVS Health; Clayton (MO); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Career growth opportunities

Job summary

CVS Health is seeking a PDE Claims Analyst to review PDE errors, analyze rejections, and coordinate responses with internal teams and external clients. The role requires interpreting CMS guidance and ensuring timely resolutions within a 40-hour week.

Ideal candidates bring proficiency in Excel, SQL, and a strong ability to manage multiple projects, with a Bachelor’s degree or equivalent experience and a focus on accuracy in Medicare claims data.

Qualifications

• 3 years minimum experience with government-regulated health programs within financial operations and/or related experience.
• Bachelor's degree preferred or equivalent work experience.

Responsibilities

• Review PDE errors and analyze PDE Rejections reports for internal and external clients.
• Coordinate research with departments and submit responses per CMS deadlines.
• Assist with weekly PDE meetings and drive continuous improvement of Medicare claims data.

Skills

Excellent written communication

Excellent verbal communication

Strong organizational skills

Time management

SQL

Education

Bachelor's degree or equivalent

Tools

Microsoft Word

Excel

SQL

Python

Job description

CVS Health is seeking a PDE Claims Analyst to review PDE errors, analyze rejections, and coordinate responses with internal teams and external clients. The role requires interpreting CMS guidance and ensuring timely resolutions within a 40-hour week.

Ideal candidates bring proficiency in Excel, SQL, and a strong ability to manage multiple projects, with a Bachelor’s degree or equivalent experience and a focus on accuracy in Medicare claims data.