ERA Reconciliation Specailist

1. Processing ERA Transactions: Receive, review, and process electronic remittance advice transactions from insurance companies and other payers.

2. Reconciliation: Match ERA transactions with corresponding claims to ensure accuracy and resolve discrepancies.

3. Analysis: Analyze ERA data to identify trends, patterns, and issues related to payment processing and reimbursement.

4. Problem Resolution: Investigate and resolve any discrepancies or issues related to ERA transactions, including denied or underpaid claims.

5. Communication: Communicate with internal departments, insurance companies, and other stakeholders to address reconciliation issues and ensure accurate payment processing.

6. Reporting: Prepare and maintain reports on ERA transactions, reconciliation activities, and payment processing metrics.

7. Compliance: Ensure compliance with healthcare regulations, payer policies, and internal procedures related to ERA transactions and payment processing.

8. Quality Assurance: Perform quality assurance checks on ERA transactions to ensure accuracy and completeness.

9. Training: Provide training and support to staff members on ERA reconciliation processes and procedures.

10. Continuous Improvement: Identify opportunities for process improvement and efficiency in ERA reconciliation processes.

Requirements for this role typically include a bachelor's degree in accounting, finance, healthcare administration, or a related field, along with experience in healthcare billing, revenue cycle management, or financial analysis. Strong analytical, communication, and problem-solving skills are also essential for success in this role.