Analyst, Business Analysis I Encounters Validation Analyst

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Analyst, Business Analysis I (Encounter Validation Analyst) is responsible for the creation, submission and tracking of encounter files to State entities in accordance with regulatory and contractual requirements. Validation Analysts also support the team in achieving business results through research and resolution of internal and external encounter edits.

Fundamental Components

• Prepare, submit and track 837 encounter files according to state and federal regulations.
• Monitor and track State response files.
• Manage vendor files submissions and monitor for accuracy and timeliness. Coordinates corrections as needed.
• Complete State attestation reports.
• Assist with testing of related system enhancements and defects.
• Research and resolve encounter related inquiries.
• Assist in correcting both internal and external rejects in an accurate and timely manner.
• Assist in the development of documentation to support encounter validation and team processes.

Required Qualifications

1+ years’ work experience with HIPAA transaction sets, claims processing and / or encounters

Problem solving and decision-making skills.

Strong written and verbal communication skills.

Strong organizational skills and ability to work as part of a team.

Preferred Qualifications

Claims / Encounters experience.

QNXT or Edifecs experience.

1+ years of experience preparing, validating, submitting, loading, and tracking 837 encounter files.

Experience with Electronic Data Interchange (EDI) files.

Education

High School Diploma or equivalent experience

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is :

$21.10 - $40.90

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit

We anticipate the application window for this opening will close on : 02 / 28 / 2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.