Medicare PDE & Claims Data Analyst

CVS Health; Wilmington (VT); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus program

Job summary

CVS Health is seeking a claims and PDE data specialist to review PDE errors and coordinate resolution with CMS deadlines. You will analyze rejection reports, leverage SQL and Python to identify root causes, and liaise with the PDE team and external partners for timely responses.

This full-time role requires about 40 hours per week, with a Bachelor's degree preferred and roughly 3 years of experience in government-regulated health programs.

Qualifications

• 3 years minimum experience with government-regulated health programs.
• Experience in Medicaid, Medicare, or Exchanges preferred.
• Experience in financial operations within healthcare.

Responsibilities

• Review PDE errors and analyze PDE rejection reports.
• Coordinate research with departments and respond to clients per CMS deadlines.
• Assist with weekly PDE meetings and ensure data quality improvements.
• Serve as liaison between PDE Reporting Team and Eligibility/Reconciliation.

Skills

Communication skills

Time management

Organizational skills

Analytical thinking

Education

Bachelor's degree preferred or equivalent work experience

Tools

SQL

Python

Microsoft Word

Excel

Job description

CVS Health is seeking a claims and PDE data specialist to review PDE errors and coordinate resolution with CMS deadlines. You will analyze rejection reports, leverage SQL and Python to identify root causes, and liaise with the PDE team and external partners for timely responses.

This full-time role requires about 40 hours per week, with a Bachelor's degree preferred and roughly 3 years of experience in government-regulated health programs.