Epic Application Analyst l, II, lll, Tapestry (Core Administration, Utilization Management or Benefits)

Tapestry Core:

• Understanding of operations within the AP Claims department, including claim intake, review, and payment  

• Familiarity with integration points with other areas of business, such as eligibility, authorizations, and internal claims  

• Familiarity with the benefit structure of plans that your organization administers.  

• Familiarity with your organization's managed care vendor contracts 

• Familiarity with operations and workflows in a Management Services Organization 

• Ability to collaborate with cross-functional teams, including Claims, Utilization Management, Provider Network Operation, Case Management, Eligibility and Capitation management. 

• Strong analytical, technical, and troubleshooting skills 

• Demonstrating flexibility with respect to changing end‐user business needs 

• The ability and willingness to recognize assignments or tasks that need to be completed, to seek out additional assignments or tasks, and to help others 

• The ability to communicate information clearly and concisely with project leadership and subject matter experts 

• The ability to gain trust and establish effective relationships with Epic counterparts 

• The ability and willingness to learn new software and systems 

• Listening attentively to ensure that the intended message has been accurately received, holding responses until the person have finished making their point, and repeating information to ensure accuracy 

• Seeking, logically examining, and interpreting information from different sources to determine a problem's cause and developing a course of action to resolve the problem and to prevent its recurrence 

• The ability to persevere in difficult situations, overcome obstacles, and reachhigh levels of performance when faced with stressful work situations and time pressures 

Tapestry Membership:

• Familiarity with your managed care organization benefit structures regarding carriers, plans, and employer groups
•  Understanding of ANSI or proprietary files received
• Ability to managing enrollment file loads from payers
• Familiarity with operations and workflows in a Management Services Organization
• Ability to collaborate with cross-functional teams, including Claims, Utilization Management, Provider Network Operation, Case Management, Eligibility and Capitation management.
• Strong analytical, technical, and troubleshooting skills
• Demonstrating flexibility with respect to changing end‐user business needs
• The ability and willingness to recognize assignments or tasks that need to be completed, to seek out additional assignments or tasks, and to help others
• The ability to communicate information clearly and concisely with project leadership and subject matter experts
• The ability to gain trust and establish effective relationships with Epic counterparts
• The ability and willingness to learn new software and systems
•  Listening attentively to ensure that the intended message has been accurately received, holding responses until the person have finished making their point, and repeating information to ensure accuracy
• Seeking, logically examining, and interpreting information from different sources to determine a problem's cause and developing a course of action to resolve the problem and to prevent its recurrence
• The ability to persevere in difficult situations, overcome obstacles, and reachhigh levels of performance when faced with stressful work situations and time pressures

Tapestry Utilization Management:

• Familiarity with prior authorization requirements, utilization management content, and network structure
• Understanding of authorization policies and procedures that affect the automatic approval or denial of authorizations
• Knowledge of areas that integrate with UM or referrals, including scheduling referrals, creating authorizations from orders, and using authorizations to pay claims if installing Tapestry AP Claims
• Familiarity with operations and workflows in a Management Services Organization
• Ability to collaborate with cross-functional teams, including Claims, Utilization Management, Provider Network Operation, Case Management, Eligibility and Capitation management.
• Strong analytical, technical, and troubleshooting skills
• Demonstrating flexibility with respect to changing end‐user business needs
• The ability and willingness to recognize assignments or tasks that need to be completed, to seek out additional assignments or tasks, and to help others
• The ability to communicate information clearly and concisely with project leadership and subject matter experts
• The ability to gain trust and establish effective relationships with Epic counterparts
• The ability and willingness to learn new software and systems
• Listening attentively to ensure that the intended message has been accurately received, holding responses until the person have finished making their point, and repeating information to ensure accuracy
•  Seeking, logically examining, and interpreting information from different sources to determine a problem's cause and developing a course of action to resolve the problem and to prevent its recurrence
• The ability to persevere in difficult situations, overcome obstacles, and reachhigh levels of performance when faced with stressful work situations and time pressures