Senior Medicare PDE & Claims Analyst

CVS Health; West Virginia; Hybride; USD 47 000 - 112 000; Plein temps

Avantages offerts par ce poste

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings options

Résumé du poste

CVS Health is seeking a detail-oriented individual to review claims and PDE errors, acting as a liaison between the PDE Reporting Team and related departments to ensure timely resolution per CMS deadlines.

The role requires strong communication, organizational, and analytical skills, with experience in government-regulated health programs and proficiency in SQL or Python. This is a full-time position based in the United States.

Qualifications

• 3 years minimum experience with government-regulated health programs within financial operations and/or related experience (Medicaid, Medicare, and/or Exchanges).
• Excellent written and verbal communication skills for interaction with clients, internal partners, and government agencies.
• 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.

Responsabilités

• Review and analyze PDE (Prescription Drug Event) errors and PDE Rejections.
• Coordinate research with departments and respond to external clients or Acumen per CMS deadlines.
• Serve as liaison between PDE Reporting Team, PDE Eligibility/Reconciliation and related entities.
• Assist with weekly PDE meetings and contribute to continuous improvement of Medicare claims data.

Connaissances

Regulatory knowledge

Communication

Time management

Formation

Bachelor's degree (preferred) or equivalent

Outils

SQL

Python

Description du poste

CVS Health is seeking a detail-oriented individual to review claims and PDE errors, acting as a liaison between the PDE Reporting Team and related departments to ensure timely resolution per CMS deadlines.

The role requires strong communication, organizational, and analytical skills, with experience in government-regulated health programs and proficiency in SQL or Python. This is a full-time position based in the United States.