Business Office Manager – Nursing Home / Long-Term Care

Position Title: Business Office Manager (BOM)
Facility: Nursing Home / Long-Term Care
Reports To: Administrator / Executive Director
Department: Administration / Business Office

Position Summary

The Business Office Manager oversees and coordinates all financial, billing, and administrative functions within the nursing home. This position ensures accurate resident billing, insurance claims processing, accounts receivable management, and compliance with state and federal regulations. The BOM works directly with residents, families, department heads, and third-party payers to maintain smooth business operations and support the overall financial health of the facility.

Key Responsibilities

1. Billing & Financial Management

• Manage resident billing for Medicare, Medicaid, private insurance, managed care, and private-pay accounts.

• Ensure accurate calculation of charges, room rates, and ancillary services.

• Oversee monthly billing cycles and distribute statements to residents or responsible parties.

• Track and follow up on outstanding accounts receivable.

2. Admissions & Financial Counseling

• Participate in resident admission and re-admission processes.

• Verify insurance eligibility and benefits prior to admission.

• Provide financial counseling to residents and families regarding payer sources, co-pays, and coverage.

• Assist families with Medicaid applications and required documentation.

3. Accounts Receivable & Collections

• Maintain accurate resident financial records and audit monthly accounts.

• Manage collection efforts while complying with federal and state regulations.

• Coordinate refunds, adjustments, and corrections as needed.

4. Compliance & Regulatory Support

• Ensure billing practices follow Medicare, Medicaid, and commercial payer rules.

• Maintain required business and financial documentation for audits and surveys.

• Collaborate with the Administrator and corporate office to ensure compliance with facility policies.

5. Payroll & HR Support (if applicable)

• Assist with payroll processing and employee timekeeping.

• Maintain employee files and support HR functions depending on facility structure.
  Note: These duties vary by organization and can be included or removed as needed.

6. Resident Trust Fund Management

• Manage resident trust accounts in compliance with federal regulations.

• Maintain accurate ledgers, reconcile balances, and issue quarterly statements.

• Ensure secure handling and documentation of resident funds.

7. Office Management & Customer Service

• Supervise front office staff (receptionist, billing clerks, etc.).

• Maintain a professional, welcoming environment for residents, visitors, and staff.

• Answer business-related questions and address resident or family concerns professionally.

Qualifications

Education

• High school diploma or GED required.

• Associate or bachelor’s degree in business, accounting, healthcare administration, or related field preferred.

Experience

• 2–3 years of experience in long-term care business office operations preferred.

• Knowledge of Medicare, Medicaid, and managed care billing required.

• Experience with electronic health records and billing software (e.g., MatrixCare, PointClickCare) strongly preferred.

Skills & Competencies

• Strong understanding of long-term care billing and reimbursement.

• Excellent organizational and time-management skills.

• Strong communication and customer service skills.

• Ability to work with residents, families, and interdisciplinary teams.

• High-level accuracy with numbers and data entry.

• Ability to maintain confidentiality and comply with HIPAA standards.