Business Office Manager for Skilled Nursing Facility

Mt. Macrina Manor, a faith-based skilled nursing facility, is seeking an experienced and detail-oriented Business Office Manager to oversee the daily financial and administrative operations of the facility's business office.

The Business Office Manager (BOM) is a critical leadership role responsible for ensuring the financial health of the facility by managing all aspects of the revenue cycle, including payer source management, admissions financial counseling, resident trust fund administration, and timely Medicaid application processing.

The BOM is an expert in census reconciliation and proactively manages payer eligibility and authorization to prevent accounts receivable (AR) issues and ensure accurate billing. This role requires exceptional organization, attention to detail, and collaborative communication with both the interdisciplinary team (IDT) and external billing staff.

Essential Duties and Responsibilities:

I. Financial Counseling & Admissions Management

• Provide comprehensive financial counseling to new admissions and their families regarding their financial obligations and payment options.
• Upload financial information into PCC.
• Monitor to ensure that financial disclosures and admissions agreements are in place.
• Accurately confirm insurance benefits, copayments, and deductibles for all Managed Care plans upon admission and as needed. Verify Medicaid eligibility if appropriate.
• Ensure a smooth transition into care by clearly communicating financial requirements.

II. Census and Payer Tree Management

• Payer Eligibility & Tree Building: Review eligibility upon admission and monthly for all residents (especially Medicaid), accurately identify the correct Managed Medicaid plan, and construct and maintain a precise Payer Tree in the PointClickCare (PCC) system.
• Authorization Management: Ensure all Managed Care authorization details are timely entered into the AR Insurance Tab for both part A and Part B services.
• Retroactive Changes: Proactively communicate all retroactive payer changes or eligibility changes to the billing staff immediately to prevent surprise balances and delays. If changing from Medicaid pending to another payer, upload Medicaid approval letter to Misc tab in PCC and send to Medicaid biller.
• Medicare & Level of Care (LOC): Attend the required Medicare Meeting and maintain the PCC census Level of Care field accurately, tracking LOC drops and continued skilled care past benefits exhausted dates.
• Capitation Oversight (if applicable): Conduct a mandatory monthly review of the capitation roster to reactivate residents whose eligibility ended due to leave (Bed Hold, etc.) and to terminate capitation charges promptly for residents who elect hospice. Facility specific
• Audit & Reconciliation: Confirm all LOC cuts and payer changes timely and frequently audit and confirm Patient Personal Allowance (PPA) and NAMI adjustments.
• Dashboard Oversight: Clear Dashboard errors related to census and monitor the Dashboard for potential insurance ineligibility issues. Resolve any insurance changes.
• IDT Collaboration: Attend weekly UR and proactively make the interdisciplinary team (IDT) aware of resident’s financial obstacles and clearly explain how those challenges may affect the resident's length of stay and discharge planning.
• Ancillary Services: Send out the census report to ancillary providers in a timely manner.

III. Resident Trust Fund Administration

• Process all resident trust transactions accurately and in a timely manner.
• Generate and deliver Quarterly Trust statements to residents and/or their representatives.
• Manage the distribution of PNA (Personal Needs Allowance) funds as requested.
• Maintain the trust petty cash box and accurately replenish petty cash from the facility’s assigned bank.
• Monitor for any resident income changes and update the state Medicaid program to adjust the PPA accordingly.

IV. Medicaid Application Processing & Tracking

• Initiate the application for Representative Payee immediately upon submission of a new Medicaid application.
• Initiate the referral to Conquest/MDR for families/residents that need to apply for Medicaid coverage.
• Monitor Medicaid FFS to Managed Medicaid changes.
• Correct inaccurate Medicaid budgets/missing coding to facility and submitting updated NAMIs/PL.
• Track and monitor Medicaid approval statuses.
• Assist the Revenue Center with Medicaid/OMIG audits.
• Submit necessary facility coding and Level of Care documentation to the state Medicaid program promptly after receiving notification of a new grant.
• Track Pending Application status and diligently update all collection notes within PCC.
• Obtain and enter an estimated PPA for all new applications from the start date into PCC.
• Participate in Medicaid Pending Review calls, update PCC with status notes.

V. Private Pay, Administration and Compliance

• Build and maintain excellent professional relationships with facility staff, outside vendors, and Revenue Center personnel.
• Ensure hospice election details are saved to the Misc. file and the census payer is updated correctly.
• Ensure that NOMNC and ABN’s are uploaded into PCC.
• Track Medicare days used.
• Provide the residents with a financial statement upon discharge.
• Maintain facility petty cash box.
• Actively participate in Triple Check Meetings to ensure billing accuracy and compliance.
• Assist families/residents with billing & statement related questionsrefer to Revenue Center if resident has been discharged.
• Private Pay collections current in house residents only.
• Mail any private pay payments that come directly to the facility to the Lockbox on a daily basis. only if lockbox is utilized
• Deposit and forward to the Revenue Center any insurance payments along with the backup (These cannot go through the lockbox).
• Attend monthly Private Pay AR reviews.

Qualifications

• Minimum of 4 years of experience in business office management, billing, and accounts receivable, preferably within a Skilled Nursing Facility (SNF) or LongTerm Care (LTC) setting.
• Deep functional expertise in payer eligibility, and Medicaid application processes.
• Expertlevel proficiency with PointClickCare (PCC), including census management, Payer Tree construction, and Collections notes.
• Demonstrated ability to communicate complex financial information clearly and compassionately to residents and family members.

Exceptional organizational skills and rigorous attention to detail, particularly with audits and reconciliation

What We Are Looking For:

The ideal candidate is a high integrity, very organized and experienced, professional, who takes ownership of their responsibilities, pays close attention to details, and follows through on commitments.

Schedule

Full-Time | Monday–Friday

Compensation

Highly competitive salary for this position is based on experience, qualifications and work ethics.

Why Join Us?

Mt. Macrina Manor is a faith-based, mission-driven skilled nursing facility, that is not a part of a large corporation.

If you are experienced and confident in your BOM skills, and looking for a new opportunity to become a part of a successful and respectful team, we encourage you to apply.

About Mt Macrina Manor

Mt. Macrina Manor is a 120 bed, not for profit, skilled nursing facility that has served Southwestern Pennsylvania since 1971. The grounds are located approximately one hour south of Pittsburgh in a scenic, peaceful rural area directly off Route 40 in Uniontown. The facility offers 24-hour nursing care, rehabilitative services, memory care, and pastoral care to all denominations. We accept all residents without regard to race, color, age, sex, national origin, religious creed, disability, or genetic information. Our mission is based upon the sponsorship of the Sisters of St. Basil the Great. Our staff continues the mission of the Sisters of providing joyous, compassionate care that preserves the human dignity of all that we serve.