Health Center Business Manager

Health Center Business Manager

Salary Range $37.08 - $44.12 Hourly Position Type Full Time Job Shift Day Category Health & Social

The Business Office Manager is responsible for the overall daily operations and financial stewardship of the Health Center Business Office, including revenue cycle management, accounts receivable, third-party payer contract management, patient registration, scheduling, and other business office functions. The position oversees the Tribal Member Health Insurance Program and supports business office functions related to Purchased Referred Care (PRC). Responsibilities include monitoring insurance eligibility and coverage, coordinating payer requirements, supporting appropriate patient financial processes, and working collaboratively with clinical and administrative departments to maximize available third-party resources.

The Business Office Manager is also responsible for provider credentialing and enrollment for insurance billing, accreditation, and other applicable requirements. Responsibilities include coordinating initial credentialing, recredentialing, payer enrollment, licensure and certification tracking, and maintaining complete and current provider records to support uninterrupted patient care, billing, reimbursement, and regulatory compliance. The position monitors key financial and revenue cycle performance indicators, identifies trends and opportunities for improvement, develops and implements corrective actions, and provides regular financial and operational reporting to Health Center leadership.

The Business Office Manager works collaboratively with providers, clinical leadership, finance, information technology, third-party payers, and other departments to ensure efficient operations, regulatory compliance, financial accountability, and the overall effective management of the Health Center Business Office.

Our philosophy is built on the principles of integrity, fairness, collaboration, communication, and recognition for performance excellence. Meeting all performance standards leads to attracting and retaining a qualified workforce, provides opportunities for qualified team members, and contributes towards the ongoing success of the Pueblo of Sandia today and in the future.

Provide leadership, direction, supervision, training, and performance management for Business Office staff, including personnel responsible for billing, coding, patient registration, scheduling, accounts receivable, insurance, PRC, and related functions. Oversee the complete revenue cycle to ensure timely and accurate charge capture, coding, claim submission, payment posting, denial management, follow-up, collections, and resolution of outstanding accounts. Monitor accounts receivable aging, denial trends, reimbursement patterns, clean claim rates, collection performance, and other key revenue cycle indicators;

develop and implement corrective action plans as needed. Ensure billing and coding practices comply with applicable federal and state regulations, payer requirements, coding guidelines, organizational policies, and other applicable compliance standards. Review and monitor third-party payer contracts, reimbursement rates, payer requirements, and operational impacts; work with leadership and payers to identify and resolve reimbursement or contract-related issues. Oversee patient registration and scheduling processes to ensure accurate demographic, insurance, eligibility, and other required information is collected and maintained.

Oversee the Tribal Member Health Insurance Program, including processes related to eligibility, enrollment, coverage verification, utilization of available benefits, and coordination with staff and third-party payers. Support and coordinate Business Office functions associated with Purchased/Referred Care (PRC), including verification of coverage, coordination of benefits, documentation, billing-related processes, and maximization of available third-party resources. Serve as the Health Center's HIM lead and provide oversight of health information management practices, including record integrity, release and disclosure of information, retention,…