Optum ยท 1 day ago
Tapestry SME Research Analyst - Kelsey Seybold Clinic
Pearland, TX
Full-time
Onsite
Senior Level
$20.38/hr - $36.44/hr
5+ years expOptum is part of the Kelsey-Seybold Clinic, one of the nation's leading healthcare organizations. The Tapestry SME Research Analyst will conduct training, support claims testing and adjudication, and maintain knowledge of Epic Tapestry Systems to enhance patient care and operational efficiency.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Conduct departmental training and one-on-one-end user development sessions
Support claims testing, troubleshooting and research relative to vendor, provider & benefit build, including referrals associated with the overall claims adjudication process
Subject Matter Expert in facility and professional claims adjudication
Support claims testing relative to system build including vendor/provider contracts and benefit build, upgrades, implementation, software and Epic Systems (Tapestry) usage
Create test scenarios to support administrative workflows, data collection, error analysis and corrections and provide written summary of research/findings to Claims Department Leadership
Support all auditing/quality performance initiatives
Maintain in depth knowledge of Epic Tapestry Systems and software, serve as liaison, identifying both user and system issues during testing and research
Perform adjudication of facility and professional claims as assigned
Resolution of assigned claim projects
Other duties as assigned
Qualification
Required
High School diploma or GED from an accredited program with equivalent industry experience
5+ years of claims adjudication experience or 2+ years of Claims Q/A or supervisory experience
Proven knowledge of Managed Care Product including contract knowledge
Demonstrated familiarity with reimbursement methodologies, CPT codes and ICD-9, ICD-10. HCPCS, DRG, Revenue Codes
Proficient use of Microsoft products including Excel, Word, Power Point
Proven solid understanding of the Accountable Care model
Demonstrable knowledge of clinical data sets (CPT, HCPCS, ICD-9, ICD-10, etc.)
Proficiency with Microsoft Word, Excel, and familiar with Access and Power Point
Valid Texas Driver's License
Preferred
Demonstrated public speaking and presentation skills
Proven excellent written and oral communication skills
Reporting experience
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase