Provider Data Specialist Resume Samples
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Provider Data Specialist Resume Samples
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DC
D Conroy
Delpha
Conroy
4272 Pouros Lake
San Francisco
CA
+1 (555) 907 3215
4272 Pouros Lake
San Francisco
CA
Phone
p
+1 (555) 907 3215
Experience
Experience
Philadelphia, PA
Provider Data Specialist
Philadelphia, PA
Reichert LLC
Philadelphia, PA
Provider Data Specialist
- Load non par providers into the system and maintain provider data
- Researches and verifies provider records for correct claims payment for both par and non-par providers
- Works as liaison to other departments that help in resolving provider issue
- Responsible for the management and upkeep of the provider E-filing system
- Perform quality assurance checks of work ensuring input accuracy meets department standards
- Assist with database improvements and audits
- Responsible for the upkeep and maintenance of provider demographics in all plan provider directories
San Francisco, CA
Provider Data Specialist
San Francisco, CA
Walsh, Schroeder and Nienow
San Francisco, CA
Provider Data Specialist
- Work with Network Management and other Beacon staff to ensure follow up with providers when applications are incomplete
- Manages provider data requests and other work assignments in the Network Connect system
- Works with Network Management and other Beacon staff to ensure follow up with providers when applications are incomplete
- Accurately enter and update provider data into Beacon’s proprietary FlexCare and Raintree systems for both In Network and Out of Network providers
- Responsible for entering and maintaining contract data and provider fee schedules for both In Network and Out of Network providers
- Conducting audits and providing feedback to reduce errors and improve processes and performance
- Support provider data validation efforts by contacting providers
present
Dallas, TX
Senior Provider Data Specialist
Dallas, TX
Rohan-Rosenbaum
present
Dallas, TX
Senior Provider Data Specialist
present
- Conducts audits and provides feedback to reduce errors and improve processes and performance
- Work is frequently completed without established procedures
- Business Partner Issue Assistance this includes assisting in many tracking projects across different business segments
- Plan, prioritize, organize and complete work to meet established objectives
- Maintains current provider data to ensure the quality of the network
- Manage Advocate outreach for providers with multiple complaints to Medicare
- Prioritize and organize own work to meet deadlines
Education
Education
Bachelor’s Degree in Personal Accountability
Bachelor’s Degree in Personal Accountability
Oregon State University
Bachelor’s Degree in Personal Accountability
Skills
Skills
- Solid analytical and problem-solving skills using reasoning and available resources to resolve issues
- Strong organizational skills, ability to prioritize and meet deadlines
- Ability to demonstrate an understanding of the operations of Provider Network and uses acquired knowledge of industry practices and standards
- Knowledgeable of current NCQA, CMS, DHCS, DMHC and other regulatory body’s credentialing standards
- Ability to work in multiple systems
- Ability to manage and resolve complex issues
- Ability to prioritize, organize and assignments
- Ability to prioritize tasks and handle multiple projects simultaneously
- Ability to define problems, collect data, establish facts, and draw valid conclusions
- Ability to understand provider contracts
5 Provider Data Specialist resume templates
Read our complete resume writing guides
1
Senior Provider Data Specialist Resume Examples & Samples
- Apply knowledge/skills to a range of moderately complex activities
- Demonstrate great depth of knowledge/skills in own function
- Proactively identify solutions to non-standard requests
- Work with team to solve complex problems
- May coordinate work of other team members
- Extensive work experience within own function
- May act as a resource for others
- May coordinate others activities
- Experience with Microsoft Excel and Word
- Inquiry or update experience with BSAR (ADR SEQ data experience)
- Inquiry access to CSP
- Experience in the Healthcare Industry
- Contract and demographic inquiry or update experience in NDB
- Customer Service experience
- Claims experience
- Provider Data Maintenance experience
- Current experience in role in which satisfactory attendance was maintained for a 12 month period
2
Provider Data Specialist Resume Examples & Samples
- Apply knowledge/skills to activities that often vary from day to day
- Require little assistance with standard and non-standard requests
- Solve routine problems on own
- Work with supervisor to solve more complex problems
- Candidate should be able to work independently with little instruction, this candidate should have data entry experience have experience with excel
- 2+ years of data entry experience
- Intermediate level proficiency with MS Word and Excel
- Experience working with healthcare providers is preferred
- Proficiency with medical terminology preferred
3
Provider Data Specialist Resume Examples & Samples
- Demonstrate a moderate level of knowledge and skills in own function
- Respond to routine or standard requests
- Experience with MS Excel required
- Experience working in production based environment required
- 1+ years of work experience in a healthcare setting
- 1+ years of Managed Care or Medical Insurance experience
- 1+ years of experience production environment meeting production and quality goals
- Proficiency in Microsoft Office Suite (ability to create and edit documents in Word; ability to sort, filter, create tables and search data in Excel)
- Experience working in Provider Relations, Medical Billing or Quality Management experience
- Experience working with healthcare providers
- Experience in medical claims processing
- Strong organizational skills, ability to prioritize and meet deadlines
4
Provider Data Specialist Resume Examples & Samples
- Researches and verifies provider records for correct claims payment for both par and non-par providers
- Load non par providers into the system and maintain provider data
- Assists in the cleanup of the current provider information, including verifying and correcting demographical errors and adding missing information such as provider specialties
- Resolves provider database issues such as addresses, user warnings, etc. and makes corrections as needed
- Communicates effectively with other departments within the platform, other dept., and externally with UHC employees who require precise database information in order to ensure claims are paid correctly
- Meets established productivity and quality standards with little or no supervision
- Takes responsibility and ownership for assignments and projects in a timely and accurate manner
- Performs other projects and duties as assigned
- Works as liaison to other departments that help in resolving provider issue
- Handle any escalated issues directed by supervisors from other areas related to claim demographics
- Must be able to work a flexible work schedule between the hours of 6:00am - 5:00pm EST, Monday – Friday
- Experience in medical claims processing (utilizing multiple claims screens to compare provider data already in the system with that of the request)
- Experience with Microsoft Word and Excel
- CSP Facets Experience
5
Senior Provider Data Specialist Resume Examples & Samples
- Data maintenance and verification
- 2+ years of Customer Service and Data Entry experience in the Healthcare Industry
- Ability to type at least 50 WPM
6
Provider Data Specialist Resume Examples & Samples
- Experience in NDB and the NDM Work Queue would be very helpful
- 2+ years of experience in the Healthcare industry
- Intermediate proficiency with Microsoft Word, Excel, and Outlook
- Experience working with Healthcare Providers
- Proficiency with Medical Terminology
7
Provider Data Specialist Resume Examples & Samples
- Ability to perform data entry and use sort/filter option in Microsoft Excel
- Healthcare experience
- Previous Data Entry experience
- Medical Claims Processing experience
- Previous experience Loading Provider Contracts
8
Provider Data Specialist Resume Examples & Samples
- Positions in this function are responsible for various activities related to the provider network database which may include any or all of the following: database maintenance, reporting and extracting data for various reports and analyses, initiating database improvement
- Develops and maintains standards for database integrity and quality assurance, coordinates corrective activities to clean database and retain users, and manages communication processes with other departments regarding database improvements
- Maintains current provider data to ensure the quality of the network
- May be responsible for representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the paper directory cycles
- Intermediate level of proficiency with MS Word and Excel
- 2+ years of experience in the healthcare industry
- 2+ years experience in medical claims processing
- Proficiency with medical terminology
9
Provider Data Specialist Resume Examples & Samples
- 2+ years of data analysis and/or audit experience within the healthcare industry
- 2+ years of customer response/customer service experience
- 2+ years of experience with Microsoft Excel, Access, and PowerPoint
- Experience tracking, trending and reporting on metrics
- Experience writing policies and procedures
10
Provider Data Specialist Resume Examples & Samples
- Responsible for working with healthcare provider groups to prepare and transmit data files to UnitedHealthcare
- Responsible for developing best practices and require that quality assurance methods are implemented within the program
- Effectively build and maintain relationships with internal and external provider clients
- Responsible for managing timelines with internal teams to ensure provider’s needs are met
- Responsible for working in a customer service environment analyzing and solving customer problems
- Undergraduate degree or equivalent to 3+ years of experience
- Intermediate level of proficiency with Access, Outlook, Word and PowerPoint
- Advanced level of proficiency with Excel
- Ability to manage time and organize a variety of concurrent projects
- Previous Customer Service experience
- Previous Experience working in a large corporate setting
- 1+ years of previous Healthcare Industry experience
- Experience working with provider office staff and/or transmission of clinical data
11
Provider Data Specialist Resume Examples & Samples
- NDB
- PHYCON
- OUTLOOK
- NAVIGATOR
- Employees in jobs labeled with (SCA) must support a government Service Contract Act (SCA) agreement
- 1+ years of experience in the Healthcare Industry
- 1+ year of experience in Customer Service
- Experience working with Healthcare Providers is preferred
- Proficiency with Medical Terminology preferred
- 1+ years of experience in Medical Claims Processing
12
Senior Provider Data Specialist Resume Examples & Samples
- Experience working in NDB would be helpful
- Experience creating correspondence and use of basic functions in Microsoft Word
- Experience performing Data Entry; sorting/filtering; and other basic functions in Microsoft Excel
- Prior Customer Service experience
- NDB experience
- Experience working with Health Care Providers
- Experience working with Medical Terminology
- Experience in Medical Claims Processing
13
Senior Provider Data Specialist Resume Examples & Samples
- Conducts audits and provides feedback to reduce errors and improve processes and performance
- Candidate should also have knowledge on the NDB platform for provider maintenance update tasks
- Experience on NICE or Pulse platforms is helpful
- 4+ years experience in the healthcare industry
- 2+ years of Data Entry experience
- 2+ years experience in Medical claims processing
- Intermediate level of proficiency with Microsoft Word and Excel
14
Senior Provider Data Specialist Resume Examples & Samples
- Must work 6+ months in office to be eligible for 'Telecommute' if you are NOT currently a telecommuter**
- 1+ years of contract and demographic inquiry or update experience in NDB
- 1+ years of experience with Microsoft Excel and Word
- 1+ years of data entry experience
- 1+ years of inquiry access to Facets experience
- Current experience in a role in which satisfactory attendance was maintained for a 12 month period
- 1+ years of inquiry or update experience with BSAR (Address Sequence data experience)
- Customer service experience
- Provider Data maintenance experience
15
Provider Data Specialist Resume Examples & Samples
- Legal background helpful
- Administrative duties include filing, copying, scanning, mailing, and responding to various forms of legal documentation such as provider Tax Levies, Subpoenas, Garnishments, etc
- Work closely with the Legal Service Specialist on documentation
- Some work is completed without established procedures
- High School Diploma/GED required
- Proficiency within Microsoft Word (creating and editing documents)
- Proficiency within Microsoft Excel (filter, sorting and entering data)
- 1+ year of Customer Service and/or Call Center experience
- Data Entry experience
- Proficiency within Microsoft Access
16
Provider Data Specialist Resume Examples & Samples
- Provider Data Specialists develop and maintain standards for database integrity and quality assurance, coordinate corrective activities to clean database and retain users, and manage communication processes with other departments regarding database improvements
- Other responsibilities include conducting audits and providing feedback to reduce errors and improve processes and performance, maintaining current provider data to ensure the quality of the network, and may be responsible for representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the paper directory cycles
- NDB platform updating experience helpful
- Loading or updating demographics and contractual information on NDB
- Work closely with the CNL's
- High school diploma/GED
- NDB provider system experience
17
Provider Data Specialist Resume Examples & Samples
- Provider Data Entry
- Data integrity and quality assurance
- 6+ months of previous Customer Service or Claims experience
- Current experience using a PC and keyboard
- Ability to type at least 50 wpm and work in multiple systems
- Ability to perform Data Entry and use sort/filter options in Microsoft Excel
- Available to work an 8-hour shift Monday through Friday starting between the hours of 6:30 am and 8:00 am
- United States Citizenship
- Ability to obtain favorable adjudication following submission of Department of Defense equip Form SF86
- Previous experience working with Behavioral Healthcare Providers
- Knowledge of Behavioral Medical Terminology
18
Senior Provider Data Specialist Resume Examples & Samples
- Prioritize and organize own work to meet agreed upon deadlines
- 3+ years of Data Entry experience
- Experience in a professional setting making outbound phone calls
19
Provider Data Specialist Resume Examples & Samples
- Support provider data validation efforts by contacting providers
- 1+ years of previous Call Center experience
- Organization
- Problem Solving, Researching, Analysis
20
Senior Provider Data Specialist Resume Examples & Samples
- May coordinate others' activities
- 1+ year of data entry experience
- Microsoft Word must be able to create and modify documents
- Microsoft Excel must be able to enter data, sort, filter, use basic formulas
- Experience working in a metric driven environment meeting Quality standards
- Healthcare claims processing experience
21
Provider Data Specialist Resume Examples & Samples
- Accurately enter and update provider data into Beacon’s proprietary FlexCare and Raintree systems for both In Network and Out of Network providers
- Updates provider demographics as needed in Network Connect
- Manages provider data requests and other work assignments in the Network Connect system
- Responsible for entering and maintaining contract data and provider fee schedules for both In Network and Out of Network providers
- Responsible for the upkeep and maintenance of provider demographics in all plan provider directories
- Assists with claims troubleshooting and reprocessing request submissions as it pertains to data entry in the provider records
- Assist providers with the commercial application request process and obtaining credentialing status
- Responsible for the management and upkeep of the provider E-filing system
- Actively participates in and completes special projects as assigned
- Attend and participate in monthly team meetings and quarterly trainings
- Meets metrics expectations as required by productivity measures
- Knowledgeable of current NCQA, CMS, DHCS, DMHC and other regulatory body’s credentialing standards
- Previous data entry required. Microsoft Word, Excel, Outlook and PowerPoint experience required
- Self-motivated, able to prioritize multiple assignments, excellent organizational skills, ability to track multiple projects/tasks and follow through as needed
- Must be detail oriented and able to work independently in a fast changing environment
- Must be able to work collaboratively with internal staff and external providers
- Ability to establish and maintain effective working relationships with providers, staff and agencies; provide a positive service attitude when dealing with internal and external customers
- Ability to demonstrate an understanding of the operations of Provider Network and uses acquired knowledge of industry practices and standards
- Experience with Provider Networks’ practices, business processes and work standard
- Must be able to meet operation demand, needs and production quota
- Ability to adapt to constantly changing priorities and managing a wide range of projects
22
Provider Data Specialist Resume Examples & Samples
- Maintenance of all provider records within the health plan system(s). Includes setup of demographic and specialty information, panel information (if applicable), line of business and fee schedule as instructed
- Assists in ensuring that Provider Directories and regulatory requirements are accurate and that errors are root caused and discussed at the global level to ensure appropriate corrections and improvements are made
- Requests for new or updates to provider records must completed within business mandated service level agreements
- Other assignments and projects as requested
- 2+ years of Customer Service experience
- Strong knowledge of standard PC packages (Microsoft Word, Excel and Outlook)
- 1+ years of previous experience in a healthcare setting/ particularly experience with managed care systems
- Knowledge of Medicaid/Medicare/Commercial rules and regulations
- Previous experience working in a production and quality environment
- Ability to utilize complex database systems and claims platforms simultaneously including, but not limited to OHBS and CSP Facets, COSMOS, and NDB
- Strong research, follow-up, documentation, and issue resolution skills
- Strong root cause analysis skills including the ability to take complex matters and format simplified key concepts to provide clear guidance to internal customers
- Experience multi-tasking and applying attention to detail
- Ability to work independently and as a team player
- Solid analytical and problem-solving skills using reasoning and available resources to resolve issues
- Independently prioritize and organize own work to complete daily tasks within required business mandated time-frames
- Ability to think independently and is not afraid to ask questions with the goal of continuous improvement in mind
- Ability to effectively adapt and adjust to changing business needs
23
Provider Data Specialist Resume Examples & Samples
- Database maintenance, reporting and extracting data for various reports and analyses, initiating database improvement
- Develop and maintain standards for database integrity and quality assurance, coordinate corrective activities to clean database and retain users, and manage communication processes with other departments regarding database improvements
- Conducting audits and providing feedback to reduce errors and improve processes and performance
- Maintaining current provider data to ensure the quality of the network, and may be responsible for representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the paper directory cycles
- NDB experience a must
- 2+ years of experience in medical claims processing
24
Senior Provider Data Specialist Resume Examples & Samples
- ORS Issue Resolution Process Management
- Issue Review and Assignment
- TAT tracking and follow-up
- Reporting creation and upkeep
- Business Partner Issue Assistance this includes assisting in many tracking projects across different business segments
- Provide subject matter expertise in the online routing system including this involves assistance in the resolution of specific errors received when routing , access and training
- Ensure issues are resolved in a timely manner by following up with owners of aged issues
- Manage Advocate outreach for providers with multiple complaints to Medicare
- Manage Sales area Exchange issues (Monty Wilson)
- Assisted with the restart of the Gatekeeper program
- Involved with PNP monthly council and C&S Resolution council
- ARIS Database quality point of contact for all ORS issues reviewed by the Quality Team
- Keeper of ORS IDS and information for the Gatekeeper program as well as the OTC Routing assignments
- NDB (Network Database) and ORS (Online Routing Systems) proficiency
- Proficiency with Microsoft Word (create and edit documents), Excel (create graphs, charts, pivot tables, and manipulate data), and SharePoint (manipulate data)
- Provider relations and/or network management experience
- Problem investigation and resolution skills
- Ability to complete work assignments and achieve results in an ambiguous work environment
- Ability to build strong, credible relationships by working across multiple groups and employee/management levels
- Ability to influence courses of action when others are directly accountable for outcomes
- Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
25
Senior Provider Data Specialist Resume Examples & Samples
- Provide explanations and information to others on topics within area of expertise
- 2+ years of work experience in a corporate setting
- 1+ years of experience with platforms Emptoris, NDB and Phycon or similar platforms
- Intermediate level of proficiency with Microsoft Excel (create spreadsheets) and Word (create documents)
- Ability to travel occasionally to attend on-site meetings
- 2+ years of managed care or medical insurance experience, specifically in credentialing providers, working in provider relations, medical billing or quality management
- Experience with Medicare
- Strong interpersonal and oral communication skills including telephone etiquette
- Strong organizational skills, ability to prioritize and meet deadlines from multi-staff members within the department
26
Senior Provider Data Specialist Resume Examples & Samples
- Cooperate when cross training and resource balancing is necessary to support business objectives
- Support overtime needs to meet TAT goals
- Work special projects as requested for business need
- NDB Experience
- Customer service experience is preferred
- Experience with Auditing preferred
27
Provider Data Specialist Resume Examples & Samples
- Accurately enter information into Beacon’s system of record
- Enter and update providers using Beacon’s proprietary FlexCare system
- Enter and Update Providers in Raintree
- Works with Network Management and other Beacon staff to ensure follow up with providers when applications are incomplete
- Filling out daily productivity log
- Responsible for reviewing and processing amendments in FlexCare
- Ensures that all providers terminated are done so in FlexCare in a in a timely manner
- Attend and participate in bi-weekly Data meeting
- Supports special projects as needed
- Answer Phones
- Meet Metrics expectations as required by productivity
- Other Duties as assigned
28
Provider Data Specialist Resume Examples & Samples
- Accurately enter provider facility, group and individual practitioner information into Beacon’s system
- Perform quality assurance checks of work ensuring input accuracy meets department standards
- Work with Network Management and other Beacon staff to ensure follow up with providers when applications are incomplete
- Responsible for tracking inbound data requests by service state and type of work
- Responsible for tracking work processed on a daily basis
- Responsible for sending out Welcome Letters to providers in a timely manner upon
- Ensure that all providers terminated are done so in Flexcare in a timely manner
- Participate in regularly scheduled team meetings
- High Level of Word, Excel, and PowerPoint
- Experience in the Healthcare industry preferred
29
Provider Data Specialist Resume Examples & Samples
- Supports requests for assistance and researches issues using various resources
- Communicates clearly, written and verbal, and follows up with various areas to ensure tasks are completed or issues are escalated appropriately
- Analyzes trends to recommend process and/or operational improvements
- Performs quality checks throughout the directory process and third party vendor process to ensure accuracy in the data
- Assists with audit reviews for accuracy and provide timely feedback on findings
- Participate in cross-functional departmental planning sessions
- Perform all other related duties as assigned by manager
- Required 1+ year of experience in research analysis
- Advanced Ability to multi-task
- Advanced Demonstrated organizational skills
- Advanced Other Requires strong project tracking
- Intermediate Other Requires solid analysis and research skills to resolve various provider related issues
- Required Advanced Microsoft Word
- Required Advanced Microsoft Outlook
- Required Intermediate Microsoft Access
30
Senior Provider Data Specialist Resume Examples & Samples
- 1+ years of experience with platforms Emptoris, NDB, and Phycon or similar platforms
- Intermediate level of proficiency with Microsoft Excel (create spreadsheets) and Microsoft Word (create documents)
- 2+ years of managed care or medical insurance experience, specifically in credentialing providers, working in provider relations, medical billing, or quality management
31
Provider Data Specialist Resume Examples & Samples
- Apply knowledge / skills to activities that often vary from day to day
- Require little assistance with standard and non - standard requests
- Work with supervisor or SME to solve more complex problems
- Experience in NDB and the NDM Work Queue
- Intermediate proficiency with Microsoft Word, Microsoft Excel, and Microsoft Outlook
- CSP experience
- 3+ years of experience in the Healthcare Industry
32
Provider Data Specialist Resume Examples & Samples
- The ability to perform data entry and use sort / filter option in Microsoft Excel
- Medical claims processing experience
- Previous experience loading provider contracts
33
Senior Provider Data Specialist Resume Examples & Samples
- High School Diploma / GED (or higher)
- 1+ years of work experience in a corporate setting
- Experience of actual Load of one of these platforms: Emptoris, NDB, PULSE, NICE and / or RCL
- Experience with Microsoft Excel (create spreadsheets) and Microsoft Word (create documents)
34
Provider Data Specialist Resume Examples & Samples
- Apply knowledge / skills to a range of moderately complex activities
- Demonstrate great depth of knowledge / skills in own function
- Sometimes act as a technical resource to others in own function
- Solve moderately complex problems on own
- Plan, prioritize, organize and complete work to meet established objectives
- Coordinate work of other team members as requested
- Work is frequently completed without established procedures
- High School Diploma / GED required
- 2+ years of customer service experience
- 1+ year of Microsoft Excel experience (Ability to filter, sort, create and edit spreadsheets)
- Ability to type 50 WPM
- Previous experience in the Health Care industry
35
Provider Data Specialist Resume Examples & Samples
- Responsible for Provider Data Entry including data maintenance and verification
- Assist with database improvements and audits
- Responsible for maintaining data integrity and quality assurance
- Solve moderately complex problems and/or conduct moderately complex issues in workup and consulting with provider relations and contracting teams for resolution as appropriate and escalating to supervisor as needed
- Responsible for ensuring provider compliance with rules and regulations as dictated by legal, the Department of Defense, URAC, and departmental policies and procedures
- Responsible for being compliant with rules and regulations in day to day activities in regards to or as dictated by legal, CHRISTUS Integrity, the Department of Defense, and URAC, NCQA, TDI, NM which can include, but is not limited to, interactions with providers and following and adhering to Departmental as well as Organizational policies and procedures
- Respond as needed to internal and external customers regarding provider participation status
- Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals
- Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
- Assist with departmental projects as needed
- Ability to understand provider contracts
- Ability to define problems, collect data, establish facts, and draw valid conclusions
- Intermediate personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheet, graphics, etc
- Ability to prioritize tasks and handle multiple projects simultaneously
- Ability to prioritize, organize and assignments
- Ability to manage and resolve complex issues
- Ability to demonstrate a high degree of personal accountability and integrity
- Work with minimal guidance; seek guidance on only the most complex tasks
- Must be able to commit to M-F 8a-5pm work shift
- 2 years or more years of experience in provider claims, data management, provider relations, preferably experience in the health insurance (HMO/PPO) industry
- Ability to work in multiple systems
- Ability to create correspondence and work within approved company templates in Microsoft Word or Excel
- Must be familiar with web based applications
- Must be able to demonstrate professional phone skills
- Understanding of provider contracts and/or contract reimbursements for data management
