Business Office Manager - Fall River HealthCare

Job Overview Summary:   

Direct the overall administrative activities and billing activities in accordance with current applicable Federal, State, and local standards, guidelines and regulations, and as directed by the Administrator, to assure that proper administrative procedures are always maintained. 

Note: The following duties are illustrative and not exhaustive. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. Depending on assigned area of responsibility, incumbents in the position may perform some or all of the activities described below. 

Functions: 

Administrative Functions 

• Assist in planning, developing, organizing, implementing, evaluating, and directing of the administrative office policies and procedures 
• Assure that all office personnel follow established policies and procedures 
• Interpret the facility's policies and procedures to personnel, residents, family members, visitors, etc., as directed by the Executive Director 
• Represent the facility at and participate in meetings as required by the Executive Director 
• Ensure administrative functions are carried out promptly for an efficient operation 
• Delegate administrative authority, responsibility and accountability to other responsible persons 
• Make written and oral reports/recommendations to the Executive Director concerning administrative procedures 
• Process administrative accounts payables invoices and vendor related inquires 
• Assure that the office is maintained in a clean and safe manner and that necessary equipment and supplies are maintained to perform required duties 
• Perform other tasks as assigned 

Billing and Billing Related Functions 

• Manages daily census changes (admissions, discharges, payer changes, room changes etc) 
• Deposits checks daily into depository account and process credit cards as requested 
• Manages resident trust funds and maintains confidential files, ensures compliance with all state and federal regulations 
• Complete month end AR close and billing for all payers or coordinate billing with the corporate biller 
• Ensure timely billing of resident liability by maintaining the correct liability in PCC 
• Manage outstanding Accounts Receivable by reviewing AR aging weekly to identify potential refunds, adjustments or rebilling and communicate with the appropriate biller 
• Document all collections efforts in PCC 
• Recommends accounts for outside collection Attorney 
• Managed Medicaid pending applications timely including coordinating referral to Medicaid Eligibility Specialist or activity working the Medicaid application 
• Manage annual redeterminations for Medicaid enrollments 
• Meets with, or ensures that another staff member meets with, all residents/responsible party upon admission and throughout the stay to explain financial obligations and paperwork 
• Audits new admission files to ensure completeness and accuracy 
• Meets with, or ensures that another staff member meets with, all residents/responsible party upon discharge to explain any remaining financial obligations 
• Communicates accounts at risk to the Administrator, prepares for and attends weekly A/R review meetings, documents collection Activities 
• Attend monthly triple check to ensure Medicare A, Medicare B and Managed Care claims are accurate prior to biller submitting claims 
• Attend weekly Medicare meeting and weekly MMQ meeting 
• Supervises, organizes, evaluates, and monitors business office operations and staff, including Business Office Assistant and receptionists (if reporting to Business Office Manager) 
• Perform other tasks as assigned 

Qualifications: 

A minimum of a high school education or high school equivalency diploma. (Required). Prior experience in the long-term care environment, specifically billing regulations (Preferred). 

Knowledge and Skills: 

• Customer Service Oriented 
• Detail oriented  
• Ability to use a computer  
• Demonstrates organizational and critical thinking skills 
• Strong interpersonal skills 
• Ability to work independently, problem solve and make decisions as necessary 
• Ability to create a resident-centered environment 
• Knowledge of policies and procedures and state and federal regulations 

Required Responsibilities: 

Successful demonstration of work standards, quality work product, productivity, and job knowledge are standard expectations for all company employees. 

Core Competencies: 

• Caring/Compassion 
• Accountability 
• Dependability 
• Adaptability/Flexibility 
• Effective Communication  
• Confidentiality  
• Team Player 
• Dedication 

Physical Demands

Shoe the amount of time on-the-job in the following physical activities by checking the appropriate boxes below.

Amount of Time

This job requires that force be exerted by weight being lifted, carried, pushed, or pulled. Show how much and how often by checking the appropriate boxes below.

This job has special vision requirements.

• Close Vision (clear vision at 20 inches or less)
• Distance Vision (clear vision at 20 feet or more)
• Color Vision (ability to identify and distinguish colors)
• Peripheral Vision (ability to observe an area that can be seen up and down or to the left and right while eyes are fixed on a given point)
• Depth Perception (three-dimensional vision; ability to judge distances and spatial relationships)
• Ability to Adjust Focus (ability to adjust eye to bring an object into sharp focus)
• No Special Vision Requirements

This job has special hearing requirements.

• Ability to hear alarms on equipment
• Ability to hear client call
• Ability to hear instructions from physician/department staff