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)

Job Summary:
The Tapestry Application Analyst supports Medicare Advantage Operations by managing and maintaining Tapestry system configuration related to claims processing, provider contracts, fee schedules, pricing, authorizations, responsibility mapping, and regulatory business rules. This role works closely with configuration leadership, IS teams, operational departments, and external vendors to ensure compliant and accurate system functionality aligned with CMS and California regulatory requirements.

Primary Responsibilities:

• Configure and maintain Tapestry claims processing functionality and business rules.
• Support AP claim lifecycle configuration and provider contract setup.
• Manage fee schedules, authorization requirements, pricing methodologies, and responsibility mapping.
• Collaborate with Configuration Manager on daily configuration operations.
• Ensure system configurations align with organizational policies, CMS requirements, and regulatory standards.
• Partner with internal technical teams and external vendors for implementation and issue resolution.
• Analyze benefit plan designs and adjudication workflows.
• Participate in implementation of new programs, projects, and system enhancements.
• Perform data analysis and present findings to operational and technical stakeholders.
• Support cross-functional initiatives involving business and IT teams.

Required Qualifications:

• Bachelor's degree in Business Administration, Healthcare, or equivalent experience preferred.
• Minimum 3 years of experience in:
  • Health Plan/IPA claims adjudication configuration.
  • Benefits configuration.
  • Provider contract configuration and analysis.
• Epic certifications in at least 2 of the following:
  • Benefits Engine for Tapestry.
  • Tapestry Accounts Payable Administration.
  • Tapestry Claims and Contracts Administration.
  • Tapestry Eligibility and Enrollment Administration.
  • Tapestry Essential.
• Strong knowledge of:
  • Medical claims adjudication.
  • Benefit plan design.
  • Contract pricing.
  • Medical policy and authorization workflows.
• Experience implementing configuration changes for new programs/projects.
• Proficiency with Microsoft Office Suite and data visualization/reporting tools.
• Strong analytical, communication, organizational, and time management skills.
• Ability to work independently and within cross-functional teams in fast-paced environments.

Preferred Qualifications:

• Experience with coding and billing.
• Experience working with both business and technical stakeholders across multiple levels of management.

Schedule:

• Monday-Friday, 8:00 AM - 5:00 PM PST.

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.