Regional Business Office Manager - AristaCare Health Services

We are looking for a Regional BOM who will be based out of our Cranford Corporate office, but must be willing to travel to our facilities as necessary.  The ideal candidate should have at least a few years of experience as a SNF  Business Office Manager with thorough knowledge of the Medicaid process.

Purpose of Your Job Position

The Business Office Manager must be familiar with company policies and procedures related to billing and accounts receivable, census processing and Medicaid applications.  The Business Office Manager processes facility information and sends it to the home office in a timely manner.  He/She interfaces with the Administrator, billers and receptionists, as well as provides verbal and written reports to the Administrator and home office.  

Job Functions

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.

Duties and Responsibilities

Administrative Functions

• Reconciling census on a daily/monthly basis; including retro adjustments of manual census and system adjustments.
• Meet w/ Admissions to review referrals that pose a potential financial issue
• Update/Reconcile Cash Sheet
• Update/Reconciling AR Log/ Aging
• Bank deposits; scanning and posting all deposits in system
• Make necessary adjustments in system for resident accounts
• Meet with resident and families  in regards to accounts
• Collections of all payors; Hospice, Medicare, Medicaid, MLTSS, Managed Care/Managed Medicare, Private
• Check claim status for all insurances via electronically or phone
• Obtain MLTSS authorizations
• Attend Utilization Review meeting on a weekly basis to discuss discharge planning of residents
• Meet with families/ potential long term residents to discuss financials and make necessary preparations
• Send requests to Office of Community Services for potential long term residents
• Send Notification request to Board of Social Services for potential Medicaid residents
• Complete Medicaid Re-determinations
• Complete Medicaid applications; submission via mail or county appointment
• Communicates with Board of Social Services caseworkers on all pending Medicaid cases/redeterminations
• Work closely with County Board of Social Services supervisors for case reinstatement
• PA 162’s– request from county, updating system with correct income and notifying families of the changes
• Submit Billing Assistance form to Provider Relations for Medicaid claims
• Submit cases to attorney if potential problem.
• Work with attorney on potential Guardianship cases
• Submit Repayee paperwork to Social Security Administration
• Submit Representative Payee Report on a yearly basis for all residents on Social Security
• Works closely with County Social Security Office supervisor to ensure all claims are processed correctly and rapidly.
• Work with pension companies to obtain pension
• Maintain yearly Bad Debt
• Handles Resident Fund Management (RFMS); opening and closing accounts, setting up direct deposit
• Supply billing with reconciled census daily and at month’s end.
• Review all outstanding accounts
• Prepare and submit Write-Offs if necessary to billing department
• Organize/ maintain resident financial files
• Communicate on a daily basis with doctor’s office/vendors on residents’ payor
• Plan, organize, and implement, the facility's Business office functions
• Maintain written policies and procedures that govern the business office functions of the facility.
• Interpret the facility's business policies and procedures to residents, family members, government agencies, etc., as necessary.
• Monitor designated home office accounting controls to assure compliance with established procedures.
• Assist in standardizing the methods in which work will be accomplished.
• Follow home office designated systems for:  financial recordkeeping to include ledgers, recording payments, writing receipts, posting cash journals, prepare and make bank deposits, etc.
• Prepare and bill specialized Equipment including and not limited to: OME Other Medical Expense, WEP Wheelchair Exception Program, VDR Vent Dependent Resident and/or DMR Durable Medical Equipment using spreadsheets, form and/or website services.
• Report delinquent accounts to your immediate manager.
• Prepare financial and statistical reports as required.
• Perform functions of computer/data processor as necessary.
• Ensure that resident admission contracts are signed and appropriately filed.
• Assist in the planning and implementation of changes in the business office system.
• Puts costumer service first:  Ensures that customers and families receive the highest quality of service in a caring and compassionate atmosphere, which recognizes the individual’s needs and rights. 
• Enrolls residents for direct deposit income (SSA, SSI, VA Benefits and pension checks) and follow up to verify completion.
• Monitors, maintains and disburses the allowance according to PA 162 form for spousal, home maintenance allowance and personal allowance for residents.
• Monitor account balance to prevent accounts from reaching the resource limit per OBRA regulations. Notify appropriate personnel to assist in spend down of excess resources.
• Mail resident statements quarterly, per state regulations

Staff Development

Attend and participate in workshops, seminars, etc., to keep abreast of current changes in the long-term care field, as well as to maintain a professional status.

Safety and Sanitation

Follow established safety regulations, to include fire protection/prevention, smoking regulations, etc.
Follow established ergonomics policies and procedures. Equipment and Supply Function

Working Conditions

• Works in office areas as well as throughout the facility.
• Moves intermittently during working hours.
• Attends and participates in continuing educational programs.

Educational Requirements

Must possess, as a minimum, a high school diploma.

Experience

Must have, as a minimum, 3 year(s) experience in health care financial administration.

Specific Requirements

• Must be able to read, write, speak, and understand the English language.
• Must possess the ability to make independent decisions when circumstances warrant such action.
• Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public.
• Must have basic training in long-term care administration and/or medical billing.
• Must possess the ability to work harmoniously with other personnel.
• Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies, and procedures, etc., that are necessary for providing sound techniques.
• Must be familiar with the laws, regulations, and guidelines governing personnel administration.
• Must be knowledgeable of micro-computers, data entry, output, system applications, etc.
• Must possess the ability to examine and verify financial documents and reports.
• Must be knowledgeable in auditing principles and practices.
• Must not pose a direct threat to the health or safety of other individuals in the workplace.

Physical and Sensory Requirements

(With or Without the Aid of Mechanical Devices)

• Must be able to move intermittently throughout the work day.
• Must be able to speak and write the English language in an understandable manner.
• Must be able to cope with the mental and emotional stress of the position.
• Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of this position can be fully met.
• Must function independently, have flexibility, personal integrity, and the ability to work effectively with personnel and support agencies.
• Must be able to relate to and work with ill, disabled, elderly, emotionally upset, and at times hostile people within the facility.

Regulatory Compliance – QAPI

• Knowledgeable in data collection, data analysis methodology, and performance improvement methods needed to support and lead performance improvement projects
• Collaborate with the quality committee and senior leaders to prioritize and develop QAPI efforts
• Lead performance improvement projects and provide education and coaching in order to build needed skills in others to lead PIPs
• Participate in multidisciplinary QAPI activities
• Knowledge of current Performance Improvement Initiatives

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