Medasource ยท 1 week ago
Claims and Benefits Analyst
United States
Full-time
Remote
Mid LevelMedasource is seeking a Claims and Benefits Analyst to support the build and configuration of claims and benefits workflows in Epic Tapestry. The role involves validating benefit setups, collaborating with various teams to troubleshoot system issues, and ensuring compliance with health plan rules.
Health CareMedical
Hiring Manager
Emmalyn Elsen
Responsibilities
Support build and configuration of claims, benefits, prior authorization, and referral workflows in Epic Tapestry
Assist in developing, executing, and documenting UAT scripts, ensuring business requirements are met and system functionality aligns with plan policies
Validate benefit setup, contract loads, fee schedules, PA rules, and claims adjudication logic
Collaborate with business analysts, project managers, IT, and operational SMEs to troubleshoot and resolve system issues during build and testing
Participate in issue tracking, root cause analysis, and resolution using tools like ServiceNow, ChangeGear, or similar
Provide guidance and expertise on Medicaid, Medicare, and Commercial health plan rules as they relate to claims and benefits processing
Contribute to process documentation, training materials, and knowledge transfer for the operational teams
Ensure regulatory compliance and adherence to project governance standards throughout build and UAT activities
Qualification
Required
Certified Claims OR Certified Benefits consultant
Experience with Epic Tapestry
Ability to develop, execute, and document UAT scripts
Knowledge of benefit setup, contract loads, fee schedules, PA rules, and claims adjudication logic
Experience collaborating with business analysts, project managers, IT, and operational SMEs
Familiarity with issue tracking and root cause analysis tools like ServiceNow, ChangeGear, or similar
Expertise on Medicaid, Medicare, and Commercial health plan rules
Ability to contribute to process documentation, training materials, and knowledge transfer
Understanding of regulatory compliance and project governance standards
Company
Medasource
Medasource is a hospital & health care company specializing in population health management and clinical engineering services.
Founded in 2000
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Abimbola ojo
EPIC OPTIME/ ANESTHESIA Consultant at Ascension
Company data provided by crunchbase