Sr. Configuration Analyst - EPIC Tapestry

The Configuration Analyst, Sr. role is responsible for the activities related to advanced system updates that can impact more
than one piece of the configuration. New health plan implementations and conversions within Business Operations. Designs
configurations solutions to meet new business requirements and performs updates for benefits, coding, contracts, fee
schedules and claim editing rules in adherence with business policies and state requirements.

• Performs daily configuration changes in claim adjudication systems.
• Performs system configuration design analysis associated with multiple areas of configuration
  with one project.
• Analyzes configuration errors and identifies required modifications.
• Supports new system implementations and upgrades.

Knowledge and Skills

• Knowledge in at least three of the areas under the purview of Med Policy Configuration: benefits, contracting, coding, fees
  schedules, or claim edits (CES).
• Knowledge of current managed care business practices and adjudication systems used by the Health Plan.
• A working knowledge of the healthcare industry, preferably health insurance/managed care.
• Collaboration, written and verbal communication, detailed analytical and organizational skills; ability to manage time with
  competing priorities; self-motivation; leadership; and ability to work independently with minimum supervision.
• Additional required knowledge includes claims processing, configuration of contracts, benefits, fee schedules, and Claims
• Editing System; ability to interpret business requirements into system coding edits, and testing of configuration builds.
  Two or more EPIC Tapestry certifications strongly preferred.

Required:

• H.S. Diploma or GED
• 4 years' experience: Managed care, claims processing, and/or configuration of benefits/contracts/fee schedules/medical policy payment rules.
  • A bachelor's degree may substitute for two (2) years of required work experience.