Shyft6

Compensation

Full Description

This is a remote position. Epic Tapestry Claims Analyst (Contract — Remote, 6–12 Months) Overview We are seeking an experienced Epic Tapestry Claims Analyst to support ongoing claims configuration, optimization, and issue resolution within our managed care and revenue cycle ecosystem. The ideal consultant will have deep experience in Tapestry Claims, including benefit configuration, pricing and adjudication logic, claims workflows, regulatory compliance, and cross-module integration. This is a remote contract role lasting 6–12 months, with occasional onsite meetings as needed. Responsibilities Lead and support Tapestry Claims build, configuration, testing, and deployment activities. Analyze requirements related to claims processing, benefit structures, contract configuration, and adjudication rules, translating them into scalable system designs. Troubleshoot claims errors, pricing discrepancies, configuration gaps, and end-to-end adjudication issues. Collaborate with operational teams (Claims, Provider Relations, Contracting, UM/CM, Finance) to optimize workflows and resolve system defects. Configure and maintain benefit plans, coverage records, provider contracts, fee schedules, claim edits, accumulators, and reimbursement logic. Support integration points with related Epic modules such as Membership, Enrollment, Referrals, PB/HB, and external payer systems. Develop test plans, execute test cases, document results, and support user acceptance testing. Participate in release and upgrade activities including regression testing, validation, and remediation. Provide knowledge transfer and mentorship to internal analysts and project stakeholders. Engagement Details Contract Length: 6–12 months Location: Fully remote with minimal onsite travel possible Start Date: ASAP Hours: Full-time (40 hrs/week) Requirements Required Qualifications Epic Tapestry Claims certification (current, former, or NVT accepted). 3+ years of professional experience supporting Epic Tapestry Claims in a build/configuration role. Strong expertise with claims adjudication logic, benefits configuration, and provider contract setup. Solid understanding of managed care processes, regulatory compliance requirements, and industry-standard claims workflows. Proven ability to troubleshoot complex claims issues and partner with operational teams to resolve root causes. Excellent communication, analysis, documentation, and stakeholder-management skills. Preferred Qualifications Experience with adjacent Epic modules such as Tapestry Benefits, Membership, Enrollment, UM/CM, PB/HB, or Resolute. Familiarity with EDI transactions (835/837), claims edits, and integration points with external payer systems. Background in payer operations, health plans, or managed care organizations. Prior consulting experience strongly preferred.