Business Office Manager

The Business Office Manager is responsible for overseeing and coordinating the daily financial and administrative business office operations of the Skilled Nursing Facility (SNF) and Home Health services within Hill View Continuing Care Retirement Community.

This position ensures the accurate and timely processing of resident and patient billing, Medicare and Medicaid reimbursement, accounts receivable, collections, financial records, and related business office functions.

The Business Office Manager works collaboratively with facility administration, nursing leadership, admissions, social services, home health personnel, and other departments to maintain financial accountability, maximize appropriate reimbursement, ensure regulatory compliance, and provide exceptional customer service to residents, patients, and families.

1. Business Office Management

• Oversee the daily operations of the business office for the Skilled Nursing Facility and Home Health services.

• Establish and maintain efficient billing, collection, recordkeeping, and financial reporting procedures.

• Ensure accurate and timely completion of assigned financial and administrative functions.

• Supervise, train, and evaluate business office personnel, as assigned.

• Maintain appropriate internal controls to safeguard organizational financial information and assets.

• Coordinate with administration and accounting personnel regarding financial performance and operational concerns.

• Identify opportunities to improve business office efficiency, reimbursement processes, and revenue cycle performance.

2. Medicare and Medicaid Billing and Reimbursement

• Oversee the preparation, submission, and follow-up of Medicare, Medicaid, managed care, private insurance, and private-pay claims.

• Ensure billing accuracy and compliance with applicable federal and Ohio reimbursement requirements.

• Monitor Medicare Part A and Part B billing processes applicable to skilled nursing services.

• Oversee Medicaid billing, eligibility verification, patient liability, and reimbursement processes.

• Coordinate with Home Health personnel to ensure appropriate Medicare, Medicaid, and commercial insurance billing.

• Monitor rejected, denied, and unpaid claims and coordinate timely resolution.

• Maintain familiarity with Medicare SNF Prospective Payment System (PDPM) and Home Health Prospective Payment System (PDGM) reimbursement requirements.

• Collaborate with clinical personnel to ensure required documentation supports accurate billing and reimbursement.

• Monitor changes in reimbursement regulations and communicate relevant changes to administration.

3. Accounts Receivable and Collections

• Oversee accounts receivable activities for the Skilled Nursing Facility and Home Health operations.

• Review accounts receivable aging reports regularly and identify delinquent accounts.

• Establish and implement appropriate collection procedures consistent with applicable laws and organizational policies.

• Follow up with insurance companies, government payers, residents, patients, and responsible parties regarding outstanding balances.

• Investigate and resolve billing discrepancies, payment delays, and account disputes.

• Coordinate payment arrangements when appropriate and authorized.

• Prepare monthly accounts receivable reports and communicate collection concerns to administration.

• Monitor collection trends, bad debt exposure, and outstanding claims to support financial stability.

• Ensure collection practices respect resident and patient rights and applicable limitations on third-party financial liability.

4. Resident and Patient Financial Accounts

• Maintain accurate resident and patient financial records, including charges, payments, adjustments, and outstanding balances.

• Coordinate financial aspects of admissions, discharges, transfers, and payer changes.

• Explain billing procedures, payment obligations, insurance coverage, and financial policies to residents, patients, and authorized representatives.

• Assist residents and families with Medicaid application and renewal processes, including coordination of required financial documentation.

• Monitor Medicaid eligibility and pending applications to minimize interruptions in reimbursement.

• Coordinate with admissions and social services to identify potential financial barriers and resolve account concerns.

• Ensure appropriate documentation of financial agreements and payer information.

• Maintain confidentiality of resident and patient financial information.

5. Home Health Business Office…