Medasource
Position Title:
Certified Claims Consultant / Certified Benefits Consultant (1 opening each)
Location:
Remote
Start Date:
ASAP
End Date:
At least on contract until August 2026 Go-Live, likely longer
Hours:
8-5 EST
Responsibilities:
Support build and configuration of claims, benefits, prior authorization, and referral workflows in Epic Tapestry.
Assist in developing, executing, and documenting UAT scripts, ensuring business requirements are met and system functionality aligns with plan policies.
Validate benefit setup, contract loads, fee schedules, PA rules, and claims adjudication logic.
Collaborate with business analysts, project managers, IT, and operational SMEs to troubleshoot and resolve system issues during build and testing.
Participate in issue tracking, root cause analysis, and resolution using tools like ServiceNow, ChangeGear, or similar.
Provide guidance and expertise on Medicaid, Medicare, and Commercial health plan rules as they relate to claims and benefits processing.
Contribute to process documentation, training materials, and knowledge transfer for the operational teams.
Ensure regulatory compliance and adherence to project governance standards throughout build and UAT activities.
Seniority level Associate
Employment type Full-time
Job function Information Technology
Industries Hospitals and Health Care
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Certified Claims Consultant / Certified Benefits Consultant (1 opening each)
Location:
Remote
Start Date:
ASAP
End Date:
At least on contract until August 2026 Go-Live, likely longer
Hours:
8-5 EST
Responsibilities:
Support build and configuration of claims, benefits, prior authorization, and referral workflows in Epic Tapestry.
Assist in developing, executing, and documenting UAT scripts, ensuring business requirements are met and system functionality aligns with plan policies.
Validate benefit setup, contract loads, fee schedules, PA rules, and claims adjudication logic.
Collaborate with business analysts, project managers, IT, and operational SMEs to troubleshoot and resolve system issues during build and testing.
Participate in issue tracking, root cause analysis, and resolution using tools like ServiceNow, ChangeGear, or similar.
Provide guidance and expertise on Medicaid, Medicare, and Commercial health plan rules as they relate to claims and benefits processing.
Contribute to process documentation, training materials, and knowledge transfer for the operational teams.
Ensure regulatory compliance and adherence to project governance standards throughout build and UAT activities.
Seniority level Associate
Employment type Full-time
Job function Information Technology
Industries Hospitals and Health Care
#J-18808-Ljbffr