Business Office Manager - Skilled Nursing, Long-Term Care Healthcare

The Opportunity:

The Business Office Manager (BOM) for a Skilled Nursing, Long-Term Care Healthcare setting is responsible for overseeing the daily financial and administrative operations of the facility's business office. This role ensures accurate census management, billing, collections, cash controls, insurance verification, reimbursement processes, and regulatory compliance. The BOM plays a critical role in maintaining financial performance, revenue cycle integrity, and exceptional customer service for residents, families, payors, and external partners.

Key Responsibilities

Census Management & Daily Revenue Operations

• Manage and reconcile daily census activity to ensure accuracy of admissions, discharges, transfers, payer changes, and room moves.
• Utilize PCC Dashboard to review and validate census data.
• Verify insurance coverage, eligibility, benefit periods, and dates used.
• Enter and maintain authorizations timely and accurately.
• Process all payor changes in billing systems and census records.
• Maintain and update census spreadsheets and internal tracking reports.
• Complete PA Health and Wellness reporting requirements accurately and on time.
• Conduct 72-hour insurance reviews for all new admissions to confirm coverage and reimbursement opportunities.

Cash Management & Deposits

• Prepare and process daily deposits.
• Complete Bankwell check deposits accurately and timely.
• Reconcile and process Sola transactions.
• Enter manual care costs in RFMS when required.
• Maintain internal controls related to cash receipts and deposits.

Billing & Collections

• Oversee collections for Private Pay and PL accounts while maintaining 95%+ collection performance.
• Review monthly resident statements and invoices for accuracy prior to distribution.
• Ensure timely mailing or electronic delivery of monthly bills.
• Conduct collection calls for past due accounts professionally and consistently.
• Coordinate magistrate filings and court-related collection actions when necessary.
• Manage guardianship-related account matters and communication.
• Process approved refund requests within 30 days.
• Maintain aging reports and execute collection strategies to reduce outstanding AR.

Triple Check & Billing Compliance

• Participate in Triple Check process to ensure accurate billing prior to claim submission.
• Review UB claims for completeness, accuracy, payer compliance, and supporting documentation.
• Resolve billing discrepancies before submission.
• Collaborate with clinical and admissions teams to support clean claims and timely reimbursement.

Utilization Review (UR)

• Conduct weekly Utilization Review meetings/processes.
• Monitor payer coverage, authorizations, continued stay criteria, and reimbursement opportunities.
• Coordinate with clinical leadership to ensure documentation supports skilled coverage.

Leadership & Administration

• Supervise business office staff as assigned.
• Train team members on billing systems, collections procedures, and customer service standards.
• Maintain resident trust accounts, if applicable.
• Ensure confidentiality of financial and resident information.
• Support audits, month-end close, and special financial projects.
• Promote a professional, service-oriented environment for residents and families.

Qualifications

• High school diploma required; Associate's or Bachelor's degree preferred in Business, Accounting, Healthcare Administration, or related field.
• Minimum 3 years of Business Office, Billing, Accounts Receivable, or Revenue Cycle experience in Skilled Nursing, Long-Term Care, or Healthcare setting required.
• Prior supervisory experience preferred.
• Strong knowledge of Medicare, Medicaid, Managed Care, Private Pay billing, and collections.
• Experience with PCC, RFMS, and healthcare billing systems preferred.
• Understanding of UB claims, Triple Check, and census management required.

Required Skills

• Strong analytical and organizational skills
• High attention to detail and accuracy
• Knowledge of reimbursement and revenue cycle processes
• Effective communication and collections skills
• Ability to manage multiple deadlines
• Professional handling of sensitive financial matters
• Strong Excel and reporting skills
• Problem-solving and follow-through mindset

Performance Expectations

• Maintain census and billing accuracy above established standards
• Achieve 95%+ collections on applicable accounts
• Ensure deposits are completed daily and accurately
• Submit clean claims timely
• Process refunds within 30 days
• Maintain regulatory and payor compliance standards