Business Office Manager

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, is an essential function of the position or as needed for the administration of the facility.

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

· 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 162s 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 Re-payee 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 months 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 doctors 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 individuals 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.

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