Epic Tapestry Analyst

Job DescriptionThe 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.

Preferred Qualifications

• 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.

Technical Skills

• 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

Preferred Certifications

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