Business operations manager serp_jobs.h1.location_city

DEPARTMENT : Administration REPORTS TO : Administrator

POSITION SUMMARY : The Business Office Manager “BOM” must be familiar with company policies and procedures related to all areas of Revenue Cycle Management, which includes census, ancillaries, billing, adjustments, deposits, collections, Medicaid Pending and resident funds. The BOM must also have a working knowledge of accounts payable. The BOM oversees all business office functions and is responsible for ensuring policy and procedure compliance in all related areas. The BOM must strive to meet all RCM goals. This position regularly interfaces with the Administrator and other department heads including admissions, clinical, social service, etc. They also interface with responsible parties, attorneys and outside agencies on financial issues.

RESPONSIBILITIES / ACCOUNTABILITIES :

1. Ensures systems and controls are in place and adheres to all policy and procedures outlined in policy manuals and meets established daily, weekly and monthly deadlines;

2. Follows RCM business processes and oversees timely and accurate completion of all business office functions in the areas of census, ancillaries, billing, adjustments, collections, write offs, refunds and deposits;

3. Manages all Resident Trust Funds procedures and ensures strict compliance with all state and federal regulations as well as company policies and maintains confidential files;

4. Conducts a 72-hour financial meeting with new admissions (resident and / or responsible party) to explain financial obligations and paperwork, reviews uploaded admission files and reports on missing financial information to center team;

5. Complies with and monitors staff compliance with segregation of duties for cash handling and posting;

6. Meets with residents / responsible parties upon discharge to explain any remaining financial obligations;

7. Monitors private spend down and timely conversions to Medicaid Pending; manages Medicaid Pending tracking and all related processes including county escalation to obtain approvals and use of outside attorney for Guardianship or assistance with uncooperative resident / family;

8. Ensures private advance billing is completed according to scheduled date and deadline; manages all month end processes, which includes completion of data entry, review and correction of trial claims, census reconciliation and all other checklist tasks; ensures deadlines are met and month end close is completed by the established time on the third workday;

9. Manages the center accounts receivable collection responsibilities for private pay following the collection timeline; manages collections of decentralized payers; ensures accurate census and billing information for the timely filing of third party claims;

10. Strives to meet RCM goals which include bad debt expense, cash collections, private credit reduction and other goals as communicated by RCM leadership; analyzes bad debt expense results and develops action plans for improvement as applicable;

11. Participates and / or coordinates routine Revenue Cycle Management Reviews and maintains collection notes in the PCC collection module for payers the center is responsible for; keeps Administrator abreast of collection issues and requests escalation as needed; monitors collection notes on third party accounts.

12. Recommends and prepares accounts for outside collection agencies, attorneys, and write off as applicable;

13. Attends center morning meetings, IDT / UM / UR meetings and other center or RCM required meetings and calls;

14. Puts customer service first : Ensures that residents and families receive the highest quality of service in a caring and compassionate atmosphere which recognizes the individuals’ needs and rights;

17. Performs other duties as assigned.

COMPLIANCE

1. Complies with applicable legal requirements, standards, policies and procedures including but not limited to those within the Compliance and Ethics Program, Standard / Code of Conduct, Federal False Claims Act and HIPAA.

2. Participates in required orientation and training programs.

3. Cooperates with monitoring and audit functions and investigations.

4. Participates, as requested, in quality assurance and process improvement activities.

SPECIFIC EDUCATIONAL / VOCATIONAL REQUIREMENTS :

1. High school degree with a minimum of five years’ experience in long term care billing and collection experience preferred.

2. Additional coursework in accounting / finance is recommended.