Day-to-Day Responsibilities:

• Epic Tapestry Configuration: Build and maintain provider contract logic, pricing rules, and reimbursement structures within Tapestry (payer contract management + accounts payable modules)

• Contract Translation: Interpret provider agreements and translating into system configuration (CDID documentation)

• Transportation Contract Configuration: Configure and maintain transportation-specific contracts (ambulance, air ambulance, rideshare, patient transport) within Tapestry

• Triplet Setup: Configure and manage provider/vendor/facility “triplets” to ensure accurate claim linkage

• Payment Methodologies: Configure fee schedules, per diem, and case-based payment models

• Testing & QA: Perform unit + regression testing to validate configuration accuracy

• Root Cause Analysis: Investigate claim/payment errors and implement configuration fixes

• Work Queue Management: Clear claims/CRMs and optimize auto-adjudication rates

• Compliance: Ensure configurations align with state/federal regulations

• Documentation: Maintain detailed build documentation and traceability

Must Have:

• 3–5+ years of experience in healthcare claims, benefits, or configuration

• Active Epic Tapestry Certification (REQUIRED – must be current, not expired)

• Hands-on experience with system configuration (Epic Tapestry strongly preferred)

• Strong understanding of provider contracts and reimbursement methodologies

• Experience with medical coding (ICD-10, CPT, HCPCS)

• Proven root cause analysis and problem-solving skills

• High attention to detail with a focus on accuracy and quality

• Strong communication skills (ability to translate technical + business requirements)
• Location Requirement: Must reside in one of the following states:
  California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, or Washington