Senior Medicare Claims & PDE Analyst

CVS Health; Austin (TX); On-site; USD 47,000 - 112,000; Full time

Job summary

CVS Health in Austin, Texas is seeking a claims analyst to review and analyze PDE errors, coordinating with the PDE Reporting Team and other departments to ensure timely resolutions. You will study CMS guidance and provide accurate responses to external clients based on research outcomes.

The role requires 3+ years in health program operations, strong communication, and proficiency with SQL, Python, and MS Office. A full-time schedule with standard benefits is offered in a healthcare environment.

Qualifications

• Minimum 3 years of experience with government-regulated health programs within financial operations.
• Strong written and verbal communication with clients and internal partners.
• Experience interpreting CMS guidance.
• Ability to coordinate with multiple departments and meet deadlines.

Responsibilities

• Review claims and PDE errors and analyze PDE rejections.
• Distribute PDE Rejections reports to clients and internal teams.
• Coordinate research with various departments and respond to external clients.
• Assist with weekly PDE meetings and drive process improvements.

Skills

Healthcare compliance

Attention to detail

Communication skills

Education

Bachelor's degree preferred or equivalent work experience

Tools

SQL

Python

Microsoft Word

Excel

Job description

CVS Health in Austin, Texas is seeking a claims analyst to review and analyze PDE errors, coordinating with the PDE Reporting Team and other departments to ensure timely resolutions. You will study CMS guidance and provide accurate responses to external clients based on research outcomes.

The role requires 3+ years in health program operations, strong communication, and proficiency with SQL, Python, and MS Office. A full-time schedule with standard benefits is offered in a healthcare environment.