Billing Office Manager

Business Office – Section 21 Residential Services and Section 13 Targeted Case Management

The Business Office Manager oversees the day-to-day financial operations of the agency, including payroll, MaineCare billing, service authorizations, accounts payable, and accounts receivable.

In this role, the Business Office Manager ensures that staff are paid accurately and on time, that services are properly authorized and billed, and that the agency’s revenue and expenses are recorded, tracked, and reconciled in full compliance with MaineCare and organizational requirements.

The Business Office Manager reports directly to the CEO and works closely with clinical, case management, and residential leadership to support the financial health and sustainability of the agency.

1. Payroll Administration

●      Payroll Processing: Processing payroll accurately and on schedule in conjunction with Human Resources, using time cards verified by HR to calculate hours, overtime, and differentials.

●      Payroll Records & Changes: Coordinating with Human Resources, which enrolls new hires, to ensure payroll records accurately reflect new employees, terminations, rate changes, deductions, and paid time off.

●      Payroll Compliance & Reconciliation: Reconciling payroll reports against the general ledger, supporting payroll tax filings and year-end W-2 processing, and resolving employee pay questions promptly and professionally.

2. MaineCare Billing & Revenue Cycle

●      Claims Submission: Generating and submitting accurate MaineCare claims for Section 21 and Section 13 services on a timely, recurring schedule to support consistent cash flow.

●      Billing Accuracy & Documentation Review: Verifying that billed units match authorized services and supporting documentation before submission to minimize denials and recoupment risk.

●      Denials, Rejections & Appeals: Monitoring remittance advice, researching and correcting denied or rejected claims, resubmitting or appealing as needed, and tracking trends to prevent recurring errors.

3. Service Authorizations

●      Authorization Support: Assisting clinical and case management staff in preparing and submitting prior authorization and reauthorization requests, ensuring required information is complete and accurate.

●      Authorization Tracking: Maintaining a current tracking system of all member authorizations, including approved units, effective dates, and expiration dates, so services are never delivered or billed without a valid authorization.

●      Proactive Alerts & Follow-Up: Notifying responsible staff of upcoming expirations, unit limits, and pending decisions well in advance, and following up with MaineCare and its authorization vendors as needed.

4. Accounts Payable

●      Invoice Processing: Receiving, reviewing, coding, and entering vendor invoices in the agency’s accounting system, ensuring proper approvals and supporting documentation are on file.

●      Payment Management: Scheduling and issuing vendor payments in coordination with the Chief Financial Officer to meet due dates while supporting healthy cash flow.

●      Vendor & Expense Reconciliation: Reconciling vendor statements, grocery and activity card transactions, and expense reports, and maintaining accurate vendor records, including W-9s and 1099 reporting.

5. Accounts Receivable

●      Payment Posting: Recording MaineCare remittances and other receipts accurately and promptly, and reconciling deposits to bank statements.

●      Aging & Collections: Monitoring the accounts receivable aging report, following up on unpaid or underpaid claims and outstanding balances, and escalating collection issues as appropriate.

●      Reporting: Preparing regular billing, collections, and A/R reports for the Chief Financial Officer, highlighting trends, risks, and opportunities to improve revenue collection.

6. Compliance, Administration & Collaboration

●      Regulatory Compliance: Staying current on MaineCare billing rules, Section 21 and Section 13 policy updates, and payroll regulations, and applying changes to business office practices.

●      Audit & Month-End Support: Assisting with month-end close, account reconciliations, and preparation of records for the agency’s CPA, audits, and MaineCare reviews.

●      Team Collaboration & Process Improvement: Partnering with program leaders and administrative staff, documenting standard operating procedures (SOPs), and identifying opportunities to streamline and automate business office workflows.

●      Thorough working knowledge of MaineCare billing, authorization, and reimbursement processes.

●      Strong understanding of payroll, accounts payable, and accounts receivable practices.

●      Exceptional accuracy, attention to detail, and organizational skills.

●      Ability to manage multiple deadlines and recurring cycles with minimal supervision.

●      High level of integrity, discretion, and confidentiality in handling financial and protected health information.

●      Clear, professional communication skills with staff, vendors, and MaineCare representatives.

●      Associate’s degree in accounting, business, or a related field required; bachelor’s degree preferred. Equivalent experience may be considered.

●      Three (3) years of experience in payroll, medical billing, or business office operations preferred.

●      Experience with MaineCare billing and service authorizations strongly preferred.

●      Ability to quickly learn and use payroll, accounting, and financial tracking systems; comfort working with spreadsheets.

●      Knowledge of Section 21 residential services and Section 13 Targeted Case Management services strongly preferred.