Role Description

The ERS Mapping Specialist is responsible for configuring, maintaining, and optimizing electronic remittance advice (ERA/835) mapping within the IMAGINE platform to enable accurate and timely automated payment posting. This role ensures payer payment, adjustment, denial, and patient responsibility data are correctly interpreted and translated into system rules that support clean electronic posting, minimize manual intervention, and maximize revenue cycle efficiency. The specialist serves as a subject matter expert for remittance structure, reimbursement methodologies, and mapping accuracy while maintaining documentation and driving continuous improvements to posting performance.

Essential Functions and Tasks

• Configure and maintain ERA/835 remittance mapping rules to support automated payment posting.
• Interpret Explanation of Benefits (EOBs), payer methodologies, and remittance data elements to ensure accurate financial outcomes.
• Validate and test mapping logic for payments, contractual adjustments, denials, and patient responsibility.
• Edit and update mapping rules as payer formats or reimbursement methodologies change.
• Generate correction and exception reports to identify posting issues and root causes.
• Investigate and resolve mapping errors impacting revenue or posting accuracy.
• Maintain and update ERS Mapping Process Guide and related documentation.
• Partner with Posting, Enrollment, and Revenue Cycle teams to ensure alignment on payer requirements.
• Support continuous improvement initiatives to increase automation rates and reduce manual posting.
• Escalate systemic issues or payer anomalies to leadership with recommended solutions.
• Perform other duties as assigned in support of ERA/EDI optimization efforts.

Qualifications

• Bachelor’s Degree.
• 1+ year experience in medical billing or revenue cycle operations required.
• Experience with ERA/835 remittance processing or electronic payment posting preferred.
• Knowledge of medical terminology and coding concepts required.
• Familiarity with third-party payer billing and reimbursement processes required.

Requirements

• Strong understanding of ERA/835 remittance structures and payment logic.
• Ability to interpret EOBs and payer reimbursement methodologies.
• High attention to detail and accuracy in rule configuration.
• Analytical and problem-solving skills with ability to diagnose posting discrepancies.
• Ability to work independently in a fast-paced production environment.
• Strong organizational and documentation skills.
• Effective written and verbal communication skills.
• Proficiency with Microsoft Office Suite and standard RCM systems.

Travel

• Remote - Not required unless specifically requested in service of a particular client.

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.
• This position is also eligible for a discretionary incentive bonus in accordance with company policies.