Medicare PDE Claims Data Analyst

CVS Health; Providence (RI); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Bonus potential

Comprehensive benefits

Job summary

CVS Health is seeking a PDE Review Analyst to examine claims and PDE errors, coordinate research, and ensure timely CMS-compliant responses. You will liaise between PDE teams, external clients, and Acumen, supporting ongoing improvements in Medicare data accuracy.

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

Qualifications

• Excellent written and verbal communication skills.
• Strong organizational skills and ability to manage multiple projects simultaneously.
• Excellent time management skills as these requests are time sensitive.
• Proficiency with Microsoft Word and Excel.
• Proficiency with SQL and/or Python.

Responsibilities

• Review claims and PDE errors and analyze PDE Rejections.
• Distribute PDE Rejections reports and analyses to clients and internal/external partners.
• Coordinate research with departments and respond to external clients or Acumen per CMS deadlines.
• Assist with weekly PDE meetings and enable continuous improvement of Medicare claims data through root-cause analysis.

Skills

Communication

Time management

Organizational skills

SQL

Python

Education

Bachelor's degree or equivalent work experience

Tools

Microsoft Word

Excel

Job description

CVS Health is seeking a PDE Review Analyst to examine claims and PDE errors, coordinate research, and ensure timely CMS-compliant responses. You will liaise between PDE teams, external clients, and Acumen, supporting ongoing improvements in Medicare data accuracy.

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