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Leads healthcare network product strategy, including market solution design, partner and TPA data exchanges, network configuration and pricing, provider data and directory accuracy, new segment evaluation, and payment integration. Requires deep reimbursement and claims expertise, familiarity with 837/835 transactions and eligibility files, SQL and data-model fluency, strong requirements writing, and confidence with commercial partners.
Top Skills: 835 Remittance Transactions837 Claims TransactionsEligibility File ExchangeHipaa X12 EdiSQL
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