Epic Tapestry Claims Analyst

UnitedHealth Group•Redlands, CA

12h•$72,800 - $130,000•Remote

About The Position

The Epic Tapestry Claims Analyst is responsible for the configuration, maintenance, and optimization of Epic Tapestry Claims and integrated third‑party applications that support claims processing, benefits administration, and payer operations. This role ensures stable, compliant, and high‑quality system performance across the claims ecosystem, with a strong focus on configuration accuracy, workflow alignment, and timely resolution of operational issues. The analyst partners closely with business stakeholders, technical teams, and vendors to support ongoing enhancements, break/fix activities, and regulatory updates. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Epic Tapestry Certification (Claims or closely related module)
3+ years of hands‑on experience supporting Epic Tapestry Claims configuration and/or claims processing systems
3+ years of experience managing or supporting third‑party integrated applications in a healthcare or payer environment
3+ years of experience in claims adjudication, benefit structures, provider contracts, and payer workflows
3+ years of experience with ServiceNow or similar ITSM platforms for incident, problem, and change management
3+ years of experience analyzing complex data flows, troubleshoot integration issues, and interpret EDI transactions (e.g., 837, 835, 270/271)

Nice To Haves

Experience with Epic Bridges, EDI, or interface engines (e.g., Corepoint, Rhapsody, Mirth)
Experience supporting regulatory or compliance‑driven system changes
Background in managed care, payer operations, or revenue cycle
Familiarity with SQL, reporting tools, or data analysis techniques
Excellent communication skills and the ability to work effectively with both technical and non‑technical stakeholders

Responsibilities

Configure, maintain, and optimize Epic Tapestry Claims components, including benefit plans, claims adjudication rules, provider contracts, fee schedules, accumulators, and related workflows
Analyze and troubleshoot claims processing issues, identifying root causes and implementing sustainable solutions
Support upgrades, releases, and environment changes, ensuring claims configuration remains accurate and compliant
Collaborate with operational leaders to translate business requirements into system configuration and functional design
Manage the setup, configuration, and ongoing support of integrated third‑party applications used for claims processing, clearinghouse functions, eligibility, payment integrity, and related services
Coordinate with vendors on interface behavior, data mapping, file formats, and issue resolution
Monitor application performance, data flows, and integration points to ensure accuracy and reliability
Maintain documentation for system configuration, integration specifications, and operational procedures
Use ServiceNow for incident management, break/fix work, change requests, and release coordination
Prioritize and resolve tickets within established SLAs, ensuring clear communication with end users and stakeholders
Participate in on‑call rotation or after‑hours support as needed for critical issues or deployments
Support change management processes, including impact analysis, testing, validation, and production migration
Partner with Claims Operations, Revenue Cycle, Managed Care, and IT teams to ensure system alignment with business needs
Provide subject‑matter expertise for projects, enhancements, and regulatory initiatives
Participate in cross‑functional design sessions, workflow reviews, and optimization efforts