Epic Tapestry Claims Analyst | Redlands, California | Remote

Epic Tapestry Claims Analyst

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Epic Tapestry Claims Analyst is responsible for the configuration, maintenance, and optimization of Epic Tapestry Claims and integrated third‑party applications that support claims processing, benefits administration, and payer operations. This role ensures stable, compliant, and high‑quality system performance across the claims ecosystem, with a strong focus on configuration accuracy, workflow alignment, and timely resolution of operational issues. The analyst partners closely with business stakeholders, technical teams, and vendors to support ongoing enhancements, break/fix activities, and regulatory updates.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

• Configure, maintain, and optimize Epic Tapestry Claims components, including benefit plans, claims adjudication rules, provider contracts, fee schedules, accumulators, and related workflows
• Analyze and troubleshoot claims processing issues, identifying root causes and implementing sustainable solutions
• Support upgrades, releases, and environment changes, ensuring claims configuration remains accurate and compliant
• Collaborate with operational leaders to translate business requirements into system configuration and functional design

• Manage the setup, configuration, and ongoing support of integrated third‑party applications used for claims processing, clearinghouse functions, eligibility, payment integrity, and related services
• Coordinate with vendors on interface behavior, data mapping, file formats, and issue resolution
• Monitor application performance, data flows, and integration points to ensure accuracy and reliability
• Maintain documentation for system configuration, integration specifications, and operational procedures

• Use Service Now for incident management, break/fix work, change requests, and release coordination
• Prioritize and resolve tickets within established SLAs, ensuring clear communication with end users and stakeholders
• Participate in on‑call rotation or after‑hours support as needed for critical issues or deployments
• Support change management processes, including impact analysis, testing, validation, and production migration

• Partner with Claims Operations, Revenue Cycle, Managed Care, and IT teams to ensure system alignment with business needs
• Provide subject‑matter expertise for projects, enhancements, and regulatory initiatives
• Participate in cross‑functional design sessions, workflow reviews, and optimization efforts

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• Epic Tapestry Certification (Claims or closely related module)
• 3+ years of hands‑on experience supporting Epic Tapestry Claims configuration and/or claims processing systems
• 3+ years of experience managing or supporting third‑party integrated applications in a healthcare or payer environment
• 3+ years of experience in claims adjudication, benefit structures, provider contracts, and payer workflows
• 3+ years of experience with Service Now or similar ITSM platforms for incident, problem, and change management
• 3+ years of experience analyzing complex data flows, troubleshoot integration issues, and interpret EDI transactions (e.g., 837, 835, 270/271)

• Experience with Epic Bridges, EDI, or interface engines (e.g., Corepoint, Rhapsody, Mirth)
• Experience…