Business Office Manager- Long Term Care

Required Qualifications

• Bachelor’s degree in Accounting, Business Administration or related field preferred.
• Must have at least three (3) years of experience in a billing or supervisory capacity in the business office of a hospital, nursing home, or other related health care facility.
• Knowledgeable of skilled nursing home regulations, procedures, laws, regulations and guidelines pertaining to long-term care.

Major Duties and Responsibilities

Plans, develops, organizes, implements, evaluates and directs the overall financial operation of the facility as well as its programs and activities, in accordance with generally accepted accounting principles and current state and federal laws/regulations.

Reports the facility’s financial performance at least monthly, and more frequently as needed, to the Administrator and the Board of Managers, Directors, and/or governing body as directed.

Identifies, in conjunction with the Administrator and selected department heads, the facility’s key performance financial indicators.Establishes an ongoing system to monitor these key indicators.These key performance indicators promote the fiscal health of the facility. 

Evaluates key performance indicator outcomes with department heads to determine the need for action from leadership and/or management such as re-education or revisions related to the facility’s financial outcomes.

Develops and implements processes and systems in the Business Office to manage billing, collections (A/R), accounts payable (A/P), patient trust, liability notices, general ledger functions, business/payroll taxes, purchase orders, cash flow and all necessary business transactions using generally accepted accounting principles.

Ensures the Business Office procedures comply with regulatory requirements related to bed-hold notice requirements.

Develops and implements payroll accounting processes, including special accounting functions required by any employee benefit or retirement plans, insurance accounting required by the federal Family and Medical Leave Act, etc.

Produces monthly facility income statement. 

Prepares financial records and cost reports for submission to authorized government agencies as required by current regulations.

Utilizes and is proficient in various excel, word, adobe, and other electronic reporting formats.

Maintains schedules for capital expenses and fixed asset depreciation.

Reviews and interprets monthly financial statements and provides relevant information to the Administrator and Board of Directors, Managers, or governing body.

Makes written and oral reports/recommendations routinely and as requested.

Ensures monthly billing is completed timely using facility A/R software. 

Ensures facility’s billing checks and balances are followed by all team members as required by facility policy including but not limited to the balancing of the daily census, Medicare triple check prior to billing, etc.

Maintains working knowledge of all aspects of facility’s financial software program.

Develops and monitors accounts receivables.Reports delinquent accounts and solutions to overcome obstacles to the Administrator.

Develops and maintains written policies and procedures that govern the accounting functions of the facility.

Maintains a working knowledge of the state long term care Medicaid insurance program, Medicare Part A, B and C insurance program, and private long term care insurance programs.

Ensures pre-admission financial evaluations regarding the identification of a payer source is coordinated with the Admissions Office as part of the pre-admissions process.

Leads and coordinates daily, weekly, bi-monthly or monthly financial meetings to monitor budget compliance with facility department heads.Implements corrective action when necessary.

Leads budget development with department heads bi-annually.

Completes and analyzes facility monthly financial reports.Makes recommendations and financial projection reports to the Administrator regarding facility performance and stated objectives.

Projects and develops yearly facility budgets with the Administrator.May be expected to report projected budgets with the Administrator to the Board of Directors 

Develops and maintains positive relationships with residents, employees, and family members.

Promotes and establishes effective communication and customer service to achieve facility goals and customer satisfaction.

Supervises all Business Office personnel and their work functions.

Evaluates work performance of Business Office personnel in concert with Human Resources for expected performance outcomes.

Ensures the admissions staff’s behavior is aligned with facility financial goals.Addresses behaviors of Business Office personnel when incongruent with facility goals.

Facilitates, serves, attends or participates in various committees of the facility as necessary.

Understands, continues to learn, and teaches others about new CMS program initiatives affecting the facility’s fiscal health such as value based purchasing programs like SNF-VBP, SNF-QRP, Quality Measures, and Payroll Based Journal reporting, etc. 

Participates in QAPI or facility assessment activities as needed, such as carrying out duties assigned as part of a performance improvement committee.

Identifies and collaborates with members of the interdisciplinary team, consultants, and others when needed to identify opportunities for enhanced financial services to the residents and/or resolve issues.

Recruits talented, qualified individuals in conjunction with Human Resources to fill department positions as a key factor in building and maintaining a strong and capable Business Office team.

Promotes teamwork, mutual respect, and effective communication.Promotes positivity and active daily problem solving. 

Reads and stays informed regarding developments in the skilled nursing sector and associated support services, regulatory, business practices and other entities potentially influencing the facility’s fiscal health.

Reviews and develops a plan of correction for accounting deficiencies noted during survey inspections and provide a written copy of such plan to the Administrator.

Promotes and encourages an environment of trust within the Business Office as well as with department heads and all facility employees.

Promotes safe work practices, safety rules, and accident prevention procedures to prevent employee injury and illness.

Additional Tasks

• Treats all residents with dignity and respect.Promotes and protects all residents’ rights.
• Establishes a culture of compliance by adhering to all facility policies and procedures.Complies with standards of business conduct, and state/federal regulations and guidelines.
• Follows appropriate safety and hygiene measures at all times to protect residents and themselves.
• Maintains confidentiality of protected health information, including verbal, written, and electronic communications.
• Reports noncompliance with policies, procedures, regulations, or breaches in confidentiality to appropriate personnel.Reports any retaliation or discrimination to HR or compliance officer.
• Reports any allegations of abuse, neglect, misappropriation of property, exploitation, or mistreatment of residents to supervisor and/or administrator.Protects residents from abuse, and cooperates with all investigations. 
• Reports any occupational exposures to blood, body fluids, infectious materials, and/or hazardous chemicals in accordance with facility policy. 
• Participates in all life safety and emergency drills and trainings.Fulfills responsibilities as assigned during implementation or activation of the facility’s emergency plan.
• Reports work-related injuries and illnesses immediately to supervisor.
• Follows established infection control policies and procedures.
• As a condition of employment, completes all assigned training and skills competency.

Personal Skills and Traits Desired/ Physical Requirements/Working Conditions

• Ability to read, write, speak and understand the English language.
• Must be a supportive team member, contribute to and be an example of team work.
• Ability to make independent decisions when circumstances warrant such action.
• Ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public.
• Must have patience, tact, and willingness to deal with difficult residents, family and staff.
• Must be able to relay information concerning a resident’s condition.
• Must not pose a threat to the health and safety of other individuals in the workplace.
• Must be able to move intermittently throughout the workday.
• Meets general health requirements according to facility policy, including medical and physical exams and checking immunity status to various infectious diseases.
• Ability to assist in evacuation of residents during emergency situations.
• Ability to bend, stoop, kneel, crouch, perform overhead lifting and perform other common physical movements as needed for the position.
• May be subject to falls, burns from equipment, and/or odors throughout the day; encounter reactions from dust, tobacco smoke, disinfectants, and other air contaminants.
• Subject to exposure to infectious waste, diseases and/or conditions which include AIDS, Coronavirus, Hepatitis B, and Tuberculosis.
• May be subject to hostile or emotional residents, family members, visitors or personnel.
• Possesses leadership, supervisory skills and willingness to work harmoniously with and supervise other personnel.
• Successfully follows oral and written instructions.
• Successfully relays information concerning business office matters, residents, employees or any given subject matter.
• Willing to cope with the mental and emotional stress of the position.
• Communicates with medical, nursing staff, and all departments.
• Accepts call-backs during emergency conditions.
• Works in office and throughout the facility.
• Willing to work to task completion in spite of frequent interruptions.
• Works beyond 9-5pm (normal working hours).May work weekends, and holidays when necessary.

Compliance as a Condition of Employment and Performance Appraisal

Agreement to abide by all standards, policies, and procedures of the facility, including the facility’s compliance and ethics program, is a condition of employment.Compliance will be a factor in evaluating job performance.Violations, including failure to report violations, will result in disciplinary action, up to and including termination.

This job description is intended to convey the general scope of the major duties and responsibilities inherent in this position.Other tasks not listed here may be assigned by the Board of Managers, Board of Directors, and/or President of the company.Periodic revision may be necessary to reflect changes in expectations placed on long term care by various governmental agencies.This job description will be reviewed and/or revised annually and as needed.

Individual performance will be evaluated using the following scale:

1. Unsatisfactory: Achieves results which are far less than the standards identified for the performance factors rated.
2. Needs Improvement: Achieves results which are less than the standards identified for the performance factors rated.Exhibits the potential to become a competent performer.May be new to job or need skill development.
3. Meets Standards: Achieves results which meet the standards identified for the performance factors rated.This rating is the expected level of performance.
4. Exceeds Standards: Achieves results which usually exceed the standards identified for the performance factors rated.