** Regional Business Office Manager - Healthcare **

SUMMARY: The primary purpose of the Regional Business Office Manager is to oversee the quality of resident account services at the facility; to assure resident accounts services are provided in accordance with the facility's established policies and procedures, applicable laws and regulations, and the directions of your supervisors, who include the AR Manager, AR Supervisor and other members of management to whom such persons report; and to implement the resident account policies established by, and to assist in providing resident account services in this facility in order to assure the highest level of resident account services is maintained at all times.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Ensure your communities are implementing effective measures for timely receipts of all payments due from IDPA, Medicare, residents, and families and, also, are communicating with the facility’s bookkeeping office.
• Ensure Business Office Managers (BOM) notify residents and families of their financial obligations upon or prior to the time of admission and obtain proper documentation of each newly-admitted resident’s financial obligations is distributed, signed, and filed.
• Ensure BOM’s are educating residents and families on, and assisting them in complying with IDPA and Medicare requirements and verify each residents’ financial resources and ability to pay when applicable.
• Ensure BOM’s make monthly phone calls to responsible parties regarding missing payments; submit Medicaid Applications and complete timely follow up on pending cases; enter admit packets into MEDI within 15 days of admission and ensure proper documentation is sent to facility caseworkers; maintain monthly logs for outstanding admit packs, new admissions, MCO Verifications and pending cases.
• Make phone calls to ensure all missing payments are received, when attempts by the BOM are unsuccessful; will also submit Medicaid Applications and follow up to ensure they are completed within 30 days of admissions (when applicable); will submit admit pack and follow up on outstanding admit packs if needed; is responsible to review all logs received and take necessary action to get things accomplished and is also responsible to maintain Medicaid Pending and Pending Admit log for each home.
• Ensure BOM’s implement and monitor the facility’s established system for receiving, depositing, withdrawing and accounting for resident funds and guarantee that resident funds are available for the residents or their authorized representatives in accordance with established procedures. The RFC will conduct monthly audit to ensure this is being followed.
• Ensure that reports of all transactions and balances of each resident’s funds are reviewed and signed at least quarterly and as required for your assigned communities and all records relating to resident funds are in an orderly, professional, and secure manner.
• Responsible to provide ongoing assistance and education to increase the likelihood of application approvals. In addition, it is the RFC’s responsibility to maintain communication with their BOM’s and to stay updated with each case.
• You will be responsible to oversee the appeal process and provide education when necessary and to resolve overpayment issues with SSA when applicable.
• Other duties as assigned.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements below are representative of the knowledge, skill, and/or ability required.

• High School Diploma or equivalent required.
• Knowledge of Healthcare billing, including Medicaid and Medicare.
• Long Term Care experience, preferred.
• Ability to travel up to 50% of the time.

PHYSICAL DEMANDS: The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to move intermittently throughout the workday.
• May be necessary to assist in the evacuation of residents during emergency situations.