Medicare PDE & Claims Data Analyst

CVS Health; Georgia; Hybrid; USD 47,000 - 112,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in the United States is seeking a detail‑oriented PDE Claims Analyst to review claims and PDE errors, analyze rejections, and coordinate responses to CMS deadlines. You will serve as a liaison between the PDE Reporting Team and Eligibility/Reconciliation units to ensure timely, accurate resolution.

The role emphasizes strong communication, organization, and technical skills with Word, Excel, SQL, and Python, and requires a bachelor’s degree or equivalent experience.

Qualifications

• 3 years minimum experience with government-regulated health programs within financial operations.
• Bachelor's degree preferred or equivalent work experience required.
• Proficiency with Word and Excel; SQL and/or Python a plus.

Responsibilities

• Review claims and PDE errors and analyze PDE Rejections.
• Distribute PDE Rejections reports to internal and external clients.
• Coordinate research with departments and respond to external clients per CMS deadlines.
• Assist with weekly PDE meetings and drive continuous data quality improvements.
• Ensure CMS guidance is interpreted correctly and compliance maintained.

Skills

Communication

Organizational Skills

Time Management

Education

Bachelor's degree or equivalent work experience

Tools

Microsoft Word

Excel

SQL

Python

Job description

CVS Health in the United States is seeking a detail‑oriented PDE Claims Analyst to review claims and PDE errors, analyze rejections, and coordinate responses to CMS deadlines. You will serve as a liaison between the PDE Reporting Team and Eligibility/Reconciliation units to ensure timely, accurate resolution.

The role emphasizes strong communication, organization, and technical skills with Word, Excel, SQL, and Python, and requires a bachelor’s degree or equivalent experience.