ERA Denials/Billing Specialist

IMA Medical Group•Orlando, FL

About The Position

We are excited to announce an opening for a ERA Denials/Billing Specialist. As a ERA Denials/Billing Specialist you will be responsible for managing the electronic remittance advice (ERA) process and resolving denied claims. This position requires a keen understanding of healthcare billing processes, proficiency in navigating electronic billing systems, and the ability to effectively analyze and address denial reasons. About IMA Medical Group: IMA Medical Group is a visionary and dynamic company focused on high-quality primary care services, with doctors and professionals dedicated to the health and well-being of the elderly. With many locations throughout Central Florida, we reiterate our commitment to providing quality medical care and an exceptional experience on each visit. That is the peace of mind and convenience that our patients deserve. What We Offer: A welcoming and inclusive work environment Opportunities for professional growth and development Competitive salary and benefits package Health, Dental, and Vision Insurance 401(K) Retirement Plan with Matching Voluntary Short & Long-Term Disability Employer-Paid Life Insurance Paid Time Off, Floating Holidays, and Paid Major Holidays Employee Assistance Program (EAP) How to Apply: ARE YOU READY TO JOIN OUR TEAM? We understand your time is valuable and that is why we have a very quick and easy application process. If you feel that you are right for this position, please fill out our initial 3-minute, mobile-friendly application so that we can review your information. We look forward to meeting you! IMA Medical Group is an Equal Opportunity Employer (EOE) and we comply with all federal, state, and local anti-discrimination laws, regulations, and ordinances. IMA Medical Group participates in E-Verify, as required by the Florida Medicaid program IMA maintains a drug-free workplace in accordance with applicable Federal and State laws

Requirements

Minimum of 2 years experience in healthcare billing and claims management.
Proficiency in working with electronic health records (EHR) and billing software.
Strong analytical skills with the ability to interpret ERA files and analyze denial trends.
Excellent verbal and written communication skills.
Ability to communicate effectively with payers, internal teams, and other stakeholders.
Keen attention to detail in reviewing and reconciling claims and payment information.
Proven ability to identify and address root causes of claim denials.

Nice To Haves

Fully Bilingual (ENGLISH/SPANISH).
Athena experience.
TriZetto/Gateway preferred
Bachelor's degree in Healthcare Administration, Business, or a related field.

Responsibilities

ERA Management: Review electronic remittance advice (ERA) files received from payers to ensure accuracy and completeness. Identify and reconcile discrepancies between claims and corresponding payment information.
Denial Analysis: Analyze claim denials to determine root causes and reasons for rejection. Collaborate with relevant departments to address and rectify issues leading to denials.
Claim Resubmission: Develop and implement strategies to correct denied claims for resubmission. Ensure timely and accurate resubmission of corrected claims to maximize reimbursement.
Communication: Liaise with payers to resolve ERA discrepancies and denial-related inquiries. Communicate effectively with internal teams to provide insights into denial trends and solutions.
Documentation: Maintain detailed records of denial reasons, resolutions, and follow-up actions. Generate reports on denial trends and share findings with management.
Process Improvement: Identify opportunities for process improvement to minimize future denials. Collaborate with cross-functional teams to implement enhancements in billing and claims processes.
Training and Education: Provide training to billing and coding staff on best practices to prevent denials. Stay informed about changes in payer policies and regulations affecting claims processing.