Application Analyst - CareConnect, Tapestry

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.

Job Title: Application Analyst - CareConnect, Tapestry

Location(s): Los Angeles, CA
(Remote: Must work Monday-Friday, 8:00 AM-5:00 PM PST)

Position Overview
We are seeking an experienced Application Analyst with strong expertise in Epic Tapestry and health plan benefits configuration to support Medicare Advantage operations. This role is responsible for configuring and maintaining the Tapestry claims processing environment, ensuring compliance with business requirements, provider contracts, and regulatory guidelines. The ideal candidate has deep experience in claims adjudication, benefit configuration, provider contracts, and Epic Tapestry applications.

Key Responsibilities

• Configure and maintain Epic Tapestry applications supporting Medicare Advantage operations.
• Manage benefit configuration, provider contracts, claims adjudication rules, fee schedules, and authorization requirements.
• Support Accounts Payable (AP) claim lifecycle configuration.
• Configure responsibility mapping, pricing methodologies, and claims processing rules.
• Work closely with Configuration leadership to support day-to-day configuration activities.
• Ensure system configuration aligns with CMS regulations and applicable state healthcare requirements.
• Collaborate with technical teams, operational departments, and external vendors to implement new programs and system enhancements.
• Analyze benefit plan designs and translate business requirements into system configuration.
• Validate configuration accuracy through testing and quality assurance activities.
• Troubleshoot configuration issues and recommend process improvements.
• Prepare reports, analyze data, and communicate findings to business and technical stakeholders.
• Participate in cross-functional projects supporting system enhancements and operational initiatives.

Required Qualifications

• Bachelor's degree in Business Administration, Healthcare, or a related field, or equivalent professional experience.
• 3+ years of experience with health plan, IPA, or managed care claims adjudication configuration.
• Strong experience configuring health plan benefits within Epic Tapestry.
• Experience with provider contract configuration and claims processing.
• Thorough understanding of medical claims adjudication, member benefits, authorization workflows, and contract pricing.
• Experience implementing configuration for new programs and projects.
• Strong analytical, problem-solving, and documentation skills.
• Experience using Microsoft Excel, Word, and PowerPoint.
• Ability to manage multiple priorities in a fast-paced environment.
• Excellent written and verbal communication skills.
• Experience collaborating with business, technical, and operational stakeholders.

Required Epic Certifications
Candidates must possess certifications in at least two of the following:

• Epic Benefits Engine for Tapestry
• Tapestry Accounts Payable Administration
• Tapestry Claims and Contracts Administration
• Tapestry Eligibility and Enrollment Administration
• Tapestry Essentials

Preferred Qualifications

• Experience with medical coding and billing.
• Experience with healthcare data analysis and reporting.
• Experience supporting Medicare Advantage or managed care organizations.
• Familiarity with data visualization and reporting tools.

Preferred Experience

• Medicare Advantage
• Managed Care
• Health Plan Operations
• Claims Configuration
• Benefits Configuration
• Provider Contract Configuration
• Claims Adjudication
• Epic Tapestry Administration

Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.