Senior Medicare PDE & Claims Analyst

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

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a detail-oriented professional to review claims and PDE errors within the Medicare Part D domain. You will analyze PDE rejections, distribute reports to clients, and coordinate cross-department research to ensure timely resolution.

Responsibilities include liaising with PDE teams, supporting weekly meetings, and driving data quality improvements, with emphasis on CMS guidance compliance. A Bachelor’s degree or equivalent experience is preferred.

Qualifications

• 3 years minimum experience with government-regulated health programs.
• Excellent written and verbal communication skills.
• Proficiency with Word and Excel.
• Bachelor's degree preferred or equivalent work experience.

Responsibilities

• Review claims and PDE errors and analyze data.
• Distribute PDE Rejections reports to clients and teams.
• Serve as liaison between PDE teams and other entities.
• Coordinate research and respond to external clients per CMS deadlines.
• Support weekly PDE meetings and drive continuous improvement.

Skills

Communication

Time management

Organizational skills

Attention to detail

Education

Bachelor's degree or equivalent

Tools

SQL

Python

Microsoft Excel

Job description

CVS Health is seeking a detail-oriented professional to review claims and PDE errors within the Medicare Part D domain. You will analyze PDE rejections, distribute reports to clients, and coordinate cross-department research to ensure timely resolution.

Responsibilities include liaising with PDE teams, supporting weekly meetings, and driving data quality improvements, with emphasis on CMS guidance compliance. A Bachelor’s degree or equivalent experience is preferred.