The Contract, Configuration & Implementation Senior Analyst is responsible for the timely and accurate build and implementation of Hospital, Ancillary & Professional contractual compensation rates and terms within the Tapestry Claims system. This will involve being responsible for providing Tapestry contract configuration and functionality with the department's Contract Managers to ensure accurate interpretation and implementation of contract compensation rates. This shall also involve acting as the department's liaison with the Claims Auditing department to ensure contract auditing requirements are initiated and maintained. Additionally, as a Tapestry AC, the position will be responsible for working with the HealthConnect AC's for implementation of Tapestry Claims system upgrades, enhancements or functionality changes. As the AC, additional responsibilities will include providing training, continuing education, and the maintenance of policies and procedures pertaining to the Tapestry Claims system.
Essential Functions:
- Responsible for the timely and accurate contract configuration of all Hospital, Ancillary & Professional contracts within the Tapestry AP/Claims system.
- Responsible for the timely and accurate development and implementation of the Centers for Medicare & Medicaid Services (CMS) RBRVS code & fee schedule updates.
- Assist with the provider demographic data maintenance and audit procedures.
- Responsible as the department's liaison with the Claims Auditing department to ensure that contract auditing requirements are initiated and completed within the applicable timeframes.
- Identify, research and conduct root cause analyses and recommend improvement and/or resolution for contract build questions and issues. This will entail working cross-functionally with other key Tapestry system stakeholders to ensure resolution (e.g. Claims, Contracts & Benefits, QRM).
- As a Tapestry AC, will act as the department's liaisons with the HealthConnect AC's to ensure future upgrades, enhancements or functionality changes are implemented.
- Responsible for the development and implementation of appropriate training materials needed in order to provide continuing education and staff support of Tapestry Claims enhancements and/or business process changes. Will be required to recommend system enhancements and/or business process changes where applicable.
- Will be a key stakeholder in the design, development, implementation and testing of Contract Management software, representing the rate sheet configuration & pricing module.
- Assist the Performance Analytics department with Tapestry contract performance analyses.
- Perform other duties as assigned.
Qualifications:
Basic Qualifications:
- Bachelor's degree or equivalent-related experience.
- Epic Tapestry certification must be obtained within 6 months of employment date in role.
- Three (3) - five (5) years complex contract / claims related experience.
- Ability to multi-task and meet strict deadlines.
- Demonstrated efficiency with standard spreadsheet and word processing applications.
- Demonstrated judgment, organization, planning and control skills.
Preferred Qualifications:
- Bachelor's degree from four-year college or university.
- Epic Tapestry AC certification.
- Project Management.
- General knowledge of Sarbanes-Oxley (SOX) compliance requirements.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.