The Business Office Manager (BOM) is responsible for providing leadership and oversight to the business office department and functions including medical billing, accounts receivable, and resident trust fund management. The BOM is the primary individual responsible for the timely collection of accounts receivable from all payer sources. The BOM directly supervises the employees in the Business Office and carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws.

ESSENTIAL DUTIES & RESPONSIBILITIES GENERAL RESPONSIBILITIES

Organizes, directs, and supervises business office functions. Supervises business office personnel, evaluates performance, schedules hours, and assigns duties. Attends and participates in stand-up and other meetings as required. Ensure business office functions are adequately staffed to minimize gaps in coverage. Responsible for all aspects of the patient / resident fund management system including accurate accounting, maintenance, and security of patient / resident funds. Works closely with Admissions team to ensure expedited review and processing of any required preadmission financial reviews. Submits and tracks required forms for Medicaid payer sources including admission, level of care change, and discharge notifications in a timely manner. Ensure Medicaid applications and renewals are completed and followed-up on appropriately. Ensure that Third Party Payer Determination Letters are issued in a timely manner according to payer requirements and company policy. Monitors private pay accounts and communicates effectively with residents / families regarding Medicaid eligibility and the application process. Receives and responds to resident / family questions regarding billing in a timely manner. Ensures all mandatory training is completed on time. Performs other duties as necessary for the successful operation of the healthcare center

BILLING & CASH COLLECTIONS

Perform and/or supervise the collection of all accounts receivable items for the facility. Accurately and completely documents status updates on all accounts regularly. Reconciles room and board to daily census. Prepares accounts to ensure clean claims are sent to correct payer sources timely. Monitors aging reports and conducts follow-up on unpaid claims; takes appropriate action to correct and re-bill if necessary for reimbursement. Monitors A/R and payment reports to identify trends and underpayments; investigate causes and take appropriate steps toward resolution using professional judgment. Verify cross-over billing occurs when applicable and submit secondary claims as necessary; ensure payers are followed up on appropriately by assigned business office personnel. Prepare and mail statements and collection letters to responsible parties. Review and explain bills to residents and/or responsible parties as necessary. Makes collection calls on accounts to proactively prevent accounts from becoming delinquent. Ensures accurate application and recording of payments received on accounts. Ensure timely collection from all payer sources; Ensure Administrator and Regional Business Office Manager are aware of delinquent accounts. Responsible for timely processing of charges, adjustments, and refunds. Obtains proper authorization for credit card and/or ACH payments. Completes and submits Representative Payee (Rep Payee) applications in a timely manner as appropriate; ensures follow-up throughout payee process. Provides regular updates of revenue cycle status including cash collections, delinquent accounts, Medicaid pending updates, outstanding insurance claims, etc. to the Administrator and Regional Business Office Manager.

PREREQUISITES, SKILLS, & ABILITIES

Bachelor’s degree in healthcare finance or related field; or one to two years of related experience and/or training; or equivalent combination of education and experience. Technical knowledge of inpatient skilled nursing, managed care, and long-term care billing for Medicare and Medicaid preferred. Experience using Point Click Care (PCC) billing system preferred. Experience using National Data Care / Resident Funds Management System (RFMS) preferred. Proficient in use of Office programs including Excel, Word, Power Point, etc. Proficient personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheets, etc. Experience managing a diverse team of staff. Excellent written and verbal communication skills.