Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.
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Job Summary
- 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
Education And Experience Requirements
- 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
Knowledge, Skills, And Abilities
- 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 incentiv e bon us in accordance with company policies .
Ventra Health
Equal Employment Opportunity (Applicable only in the US)
Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.
Recruitment Agencies
Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.
Solicitation of Payment
Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.
Attention Candidates
Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.
To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at [Confidential Information] to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.
Statement of Accessibility
Ventra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.
