Job Overview
Provider Domain bull Identifying, defining and understanding the difference between health systems, facilities, ancillary and physicians. bull Understanding of provider relationships (owned (JV, acq, merger, etc), employed, affiliated, referred, rendering, etc.) bull Experience with provider identifiers (tax id, npi, medicareMedicaid id, dea number, other government ids) bull Understanding of provider demographiccontract data bull Knowledge of provider address information. Difference between billing, servicing, mailing, pay to, etc. addresses. bull Experience with provider datasets o Internal Claims (EDI 837, prepost adjudicated) Credentialing Contracting o External Vendor bull Definitive Health bull Dun Bradstreet bull Lexis Nexis bull RESdac Government bull CMS bull NPPES bull Medicare bull Medicaid bull Health.data.gov bull State health data Thanks and Regards Sachin Mishra
Job Detail
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