Senior Analyst, Medicare PDE & Claims Analytics

CVS Health; Lexington (KY); Presencial; USD 47 000 - 112 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical insurance

Dental insurance

Vision insurance

Paid time off

Retirement savings

Resumo da oferta

CVS Health is seeking a detail-oriented professional to review Medicare PDE claims and errors. You will analyze PDE Rejections, coordinate with the PDE Reporting Team and other departments, and ensure timely resolutions in line with CMS deadlines.

The role supports improving data quality through root-cause analysis and collaboration with internal and external clients. Strong communication skills and cross-functional coordination are essential.

Qualificações

• 3 years minimum experience with government-regulated health programs within financial operations and/or related experience

Responsabilidades

• Review claims and PDE (Prescription Drug Event) errors and analyze PDE Rejections reports.
• Coordinate research with multiple departments and respond to external clients or Acumen per CMS deadlines.
• Assist with weekly PDE meetings and contribute to continuous improvement of Medicare claims data.

Conhecimentos

Strong communication

Cross-functional

Attention to detail

Formação académica

Bachelor's degree or equivalent

Ferramentas

SQL

Python

Microsoft Word

Excel

Descrição da oferta de emprego

CVS Health is seeking a detail-oriented professional to review Medicare PDE claims and errors. You will analyze PDE Rejections, coordinate with the PDE Reporting Team and other departments, and ensure timely resolutions in line with CMS deadlines.

The role supports improving data quality through root-cause analysis and collaboration with internal and external clients. Strong communication skills and cross-functional coordination are essential.