Sr. Configuration Analyst - EPIC Tapestry
About The Position
The Senior Configuration Analyst is responsible for advanced system updates that may affect multiple areas of configuration, including new health plan implementations and conversions within Business Operations. The role designs configuration solutions to meet new business requirements and updates benefits, coding, contracts, fee schedules, and claim-editing rules in accordance with business policies and state requirements. The position performs daily configuration changes in claim adjudication systems, analyzes configuration design across multiple areas within a project, investigates configuration errors and identifies needed modifications, and supports system implementations and upgrades. It requires knowledge of at least three configuration areas, managed care practices and health-plan adjudication systems, and the ability to translate business requirements into system coding edits and test configuration builds.
Requirements
- High school diploma or GED.
- Four years of experience in managed care, claims processing, and/or configuration of benefits, contracts, fee schedules, or medical policy payment rules. A bachelor's degree may substitute for two years of required work experience.
- Knowledge of at least three of the following areas: benefits, contracting, coding, fee schedules, or claim edits (CES).
- Knowledge of current managed care business practices and adjudication systems used by the health plan.
- Working knowledge of the healthcare industry, preferably health insurance or managed care.
- Knowledge of claims processing, configuration of contracts, benefits, fee schedules, and the Claims Editing System.
- Ability to interpret business requirements into system coding edits and test configuration builds.
- Collaboration, written and verbal communication, analytical, organizational, time-management, self-motivation, leadership, and independent-work skills.
Nice To Haves
- Two or more EPIC Tapestry certifications are strongly preferred.
Responsibilities
- Perform daily configuration changes in claim adjudication systems.
- Perform system configuration design analysis across multiple configuration areas within a project.
- Analyze configuration errors and identify required modifications.
- Support new system implementations and upgrades.
- Design configuration solutions for new business requirements and update benefits, coding, contracts, fee schedules, and claim-editing rules in accordance with business policies and state requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
