Business Office Manager

Business Office Manager – Job Description

The Business Office Manager is responsible for overseeing the facility’s business office operations, ensuring compliance with company policies and procedures related to billing, accounts receivable, census processing, and Medicaid applications in Pennsylvania. The Manager processes facility information accurately and timely, and serves as a key liaison among the Administrator, billers, receptionists, residents, families, and the home office. This role provides both verbal and written reports to the Administrator and home office.

Duties and Responsibilities

Administrative Functions

• Reconcile census daily and monthly, including retroactive manual and system adjustments.

• Meet with Admissions to review referrals with potential financial concerns.

• Update and reconcile cash sheets, accounts receivable logs, and aging reports.

• Prepare and post bank deposits, scanning and recording all transactions in the system.

• Make necessary adjustments to resident accounts in the system.

• Meet with residents and families regarding account status, billing, and collections.

• Collect payments from all payors, including Hospice, Medicare, Medicaid, MLTSS, Managed Care/Managed Medicare, and private payors.

• Verify insurance claim status electronically or by phone.

• Obtain MLTSS authorizations as needed.

• Attend weekly Utilization Review meetings to discuss resident discharge planning.

• Meet with families and potential long-term residents to discuss financial matters and prepare necessary documentation.

• Submit requests to the Office of Community Services and Board of Social Services for potential Medicaid residents.

• Complete Medicaid applications and re-determinations via mail or county appointments.

• Communicate with Board of Social Services caseworkers regarding pending Medicaid cases and re-determinations.

• Work with county supervisors to reinstate cases when necessary.

• Handle PA 162 forms, update system records, and notify families of changes.

• Submit billing assistance requests for Medicaid claims and escalate cases to legal counsel if necessary.

• Collaborate with attorneys on potential guardianship cases.

• Process Representative Payee paperwork and annual reports for residents receiving Social Security.

• Work closely with the Social Security Administration and pension providers to ensure timely processing of claims.

• Maintain yearly bad debt records.

• Manage Resident Fund Management accounts (RFMS), including opening/closing accounts and setting up direct deposit.

• Provide billing with reconciled census data daily and at month-end.

• Review outstanding accounts and prepare write-offs as necessary.

• Organize and maintain resident financial files.

• Communicate daily with doctors’ offices and vendors regarding resident payors.

• Plan, organize, and implement all business office functions for the facility.

• Maintain written policies and procedures governing business office operations.

• Interpret business office policies and procedures for residents, families, and government agencies as needed.

• Ensure compliance with home office accounting controls.

• Assist in standardizing workflow processes within the business office.

• Follow home office systems for financial recordkeeping, including ledgers, payments, receipts, posting cash journals, and bank deposits.

• Prepare and bill for specialized equipment, such as OME, WEP, VDR, and DMR, using spreadsheets, forms, and online services.

• Report delinquent accounts to the Administrator.

• Prepare financial and statistical reports as required.

• Perform computer and data processing functions as needed.

• Ensure resident admission contracts are signed and properly filed.

• Assist in planning and implementing business office system changes.

• Deliver exceptional customer service, ensuring residents and families receive care in a compassionate and respectful environment.

• Enroll residents in direct deposit for SSA, SSI, VA benefits, and pensions; verify completion.

• Monitor, maintain, and disburse allowances according to PA 162 forms for spousal, home maintenance, and personal allowances.

• Monitor account balances to prevent exceeding OBRA resource limits, coordinating spend-down efforts when necessary.

• Mail resident statements quarterly in compliance with state regulations.

Experience

• Minimum of 3 years’ experience in healthcare financial administration is required.

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