Medicare PDE & Claims Data Analyst

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health seeks a qualified professional to review claims and PDE errors, acting as a liaison across PDE Reporting Team and related entities to ensure timely, accurate resolutions. The role requires familiarity with CMS guidance and Part D plans, with a focus on data quality and process improvement.

The position involves coordinating with internal teams and external clients, attending weekly PDE meetings, and contributing to continuous improvement initiatives.

Qualifications

• 3 years minimum experience with government-regulated health programs in financial operations.
• Bachelor's degree preferred or equivalent work experience.
• Experience with CMS guidance and Part D plans is a plus.

Responsibilities

• Review claims and PDE errors and distribute PDE Rejections reports.
• Coordinate research with departments and respond to external clients per CMS deadlines.
• Support weekly PDE meetings and drive continuous improvement of claims data.

Skills

Communication skills

Organizational skills

Time management

Attention to detail

Education

Bachelor's degree or equivalent

Tools

Microsoft Word

Microsoft Excel

SQL

Python

Job description

CVS Health seeks a qualified professional to review claims and PDE errors, acting as a liaison across PDE Reporting Team and related entities to ensure timely, accurate resolutions. The role requires familiarity with CMS guidance and Part D plans, with a focus on data quality and process improvement.

The position involves coordinating with internal teams and external clients, attending weekly PDE meetings, and contributing to continuous improvement initiatives.