Job Description

Job Description

Job Description

The Epic Tapestry Analyst is responsible for the design, configuration, implementation, optimization, testing, and ongoing support of the Epic Tapestry (Managed Care/Payer) application. This role partners with payer operations, claims, enrollment, revenue cycle, contracting, and IT teams to ensure efficient management of health plan operations, benefits, eligibility, authorizations, claims adjudication, and reimbursement workflows. 

• Configure, build, maintain, and optimize Epic Tapestry application components. 
• Support benefit plans, products, packages, coverage rules, eligibility, and enrollment workflows. 
• Configure claims adjudication logic, reimbursement methodologies, fee schedules, and payment policies. 
• Build and maintain authorizations, referrals, and utilization management workflows. 
• Support payer contracts, coordination of benefits (COB), and provider reimbursement processes. 
• Gather and analyze business requirements and translate them into Epic system solutions. 
• Perform system configuration, testing, validation, and deployment activities. 
• Execute unit testing, integrated testing, and User Acceptance Testing (UAT). 
• Troubleshoot application issues and provide production support. 
• Collaborate with Revenue Cycle, Claims, Enrollment, Contracting, Finance, and Provider Relations teams. 
• Support interfaces and integrations with Epic applications and external payer systems. 
• Develop and maintain system documentation, workflows, build specifications, and training materials. 
• Participate in implementation, optimization, upgrade, and go-live activities. 
• Ensure compliance with HIPAA, CMS, Medicare, Medicaid, and healthcare payer regulations. 

• Epic Tapestry Certification required (Claims, Membership, Enrollment & Eligibility, CRM, Utilization Management, or related Tapestry certification preferred). 
• 3+ years of Epic Tapestry build and support experience. 
• Strong understanding of payer operations, managed care, claims processing, and health plan workflows. 
• Experience with benefits configuration, eligibility, enrollment, authorizations, and claims adjudication. 
• Knowledge of healthcare regulations and payer requirements. 
• Excellent analytical, troubleshooting, and problem-solving skills. 
• Strong communication and stakeholder management abilities. 
• Experience supporting Epic implementations, upgrades, and optimization projects. 

• Experience with Medicare, Medicaid, and Commercial Health Plans. 
• Knowledge of EDI, ANSI transactions, HL7 integrations, and payer interfaces. 
• Experience with Epic Clarity, Caboodle, Reporting Workbench, or SQL reporting. 
• Familiarity with Revenue Cycle, Claims, Enrollment, and Contracting operations. 
• Prior consulting or multi-site healthcare implementation experience. 

• Epic Tapestry Configuration & Build 
• Claims Adjudication 
• Enrollment & Eligibility 
• Benefits Administration 
• Utilization Management (UM) 
• Referrals & Authorizations 
• Provider Contracting 
• EDI / ANSI Transactions 
• Reporting & Analytics 
• Workflow Analysis & Optimization 
• Testing & Validation 
• Production Support 

• Epic Tapestry Certification 
• Epic Tapestry Claims Administration 
• Epic Tapestry Membership 
• Epic Tapestry Enrollment & Eligibility 
• Epic Tapestry Utilization Managemen

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