Regional Business Office Manager

Job Title: Regional Business Office Manager

We are seeking a highly skilled and experienced Regional Business Office Manager to join our team at AristaCare. As a key member of our business office team, you will be responsible for overseeing the financial and administrative functions of our regional offices.

Key Responsibilities:

• Reconcile census on a daily and monthly basis, including retro adjustments of manual census and system adjustments.
• Meet with admissions to review referrals that pose a potential financial issue.
• Update and reconcile cash sheets, AR logs, and aging reports.
• Process bank deposits, scan and post all deposits in the system.
• Make necessary adjustments in the system for resident accounts.
• Meet with residents and families to discuss accounts and provide financial guidance.
• Collections of all payors, including Hospice, Medicare, Medicaid, MLTSS, Managed Care/Managed Medicare, and Private.
• Check claim status for all insurances via electronic or phone.
• Obtain MLTSS authorizations.
• Attend Utilization Review meetings to discuss discharge planning of residents.
• Meet with families and potential long-term residents to discuss financials and make necessary preparations.
• Send requests to the Office of Community Services for potential long-term residents.
• Send Notification requests to the Board of Social Services for potential Medicaid residents.
• Complete Medicaid Re-determinations.
• Complete Medicaid applications and submit via mail or county appointment.
• Communicate 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 the system with correct income and notifying families of the changes.
• Submit Billing Assistance forms to Provider Relations for Medicaid claims.
• Submit cases to attorneys if potential problems arise.
• Work with attorneys on potential Guardianship cases.
• Submit Repayee paperwork to the Social Security Administration.
• Submit Representative Payee Reports on a yearly basis for all residents on Social Security.
• Work closely with County Social Security Office supervisors to ensure all claims are processed correctly and rapidly.
• Work with pension companies to obtain pension.
• Maintain yearly Bad Debt.
• Handle Resident Fund Management (RFMS), including 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 the billing department.
• Organize and maintain resident financial files.
• Communicate daily with doctors' offices and vendors on residents' payors.
• Plan, organize, and implement the facility's Business Office functions.
• Maintain written policies and procedures governing 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 methods for work accomplishment.
• Follow home office designated systems for financial recordkeeping, including ledgers, recording payments, writing receipts, posting cash journals, preparing and making bank deposits, etc.
• Prepare and bill specialized Equipment, including OME, WEP, VDR, and DMR, using spreadsheets, forms, and/or website services.
• Report delinquent accounts to the immediate manager.
• Prepare financial and statistical reports as required.
• Perform functions of computer/data processor as necessary.
• Ensure resident admission contracts are signed and appropriately filed.
• Assist in the planning and implementation of changes in the Business Office system.
• Put customer service first: Ensure customers and families receive the highest quality of service in a caring and compassionate atmosphere, recognizing individual needs and rights.
• Enroll residents for direct deposit income (SSA, SSI, VA Benefits, and pension checks) and follow up to verify completion.
• Monitor, maintain, and disburse the allowance according to PA 162 form for spousal, home maintenance allowance, and personal allowance for residents.
• Monitor account balances 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, including fire protection/prevention, smoking regulations, etc.
• Follow established ergonomics policies and procedures.

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:

• Must be able to move intermittently throughout the workday.
• 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.

---