Business Office Manager (Full-Time)

Job Title: Business Office Manager 

Department: Business Office 

Reports To: Administrator 

FLSA Status: Exempt 

SUMMARY:

Manage and oversee the daily activities and business operations of the department. Knowledgeable in Medicare, Medicaid, Worker’s Compensation and Third Party Payer claim processing. Knowledgeable in bookkeeping, computer skills as related to claims processing and organizational skills. 

QUALIFICATIONS: 

• Communicates in an effective manner, follow written or verbal instructions and demonstrates good interpersonal skills to deal with team members, patients and families. 
• Knowledge of insurance policies. 
• Competent with the accounts receivable accounting system. 
• Knowledgeable in accounting procedures. 
• Competent in Microsoft Office Word and Excel. 
• Maintain discretion and confidentiality in communications. 
• Familiar with policies and procedures regarding reporting and release of protected health information (PHI). 

ESSENTIAL DUTIES AND RESPONSIBILITIES: 

• Ensures the Business Office is open and ready for business at the beginning each business day. 
• Provides oversight to ensure patient claims are filed with the appropriate insurance carrier in a timely manner. 
• Provides oversight to ensure patients are greeted appropriately, registered on the computer system and all necessary insurance information is compiled along with all required patient forms. 
• Provides oversight to ensure all required logs are being completed accurately and in a timely manner. 
• Maintains personnel schedules and vacations with little or no overtime. 
• Assists Administrator in securing any temporary employees required to cover vacations/sick leaves. 
• Supervises and/or trains employees in all functions of the Business Office. 
• Prepares performance reviews for the department employees on a timely basis and maintains thorough written reports regarding any discussions, reprimands, etc. with office staff regarding professional insufficiencies or behavioral issues. 
• Maintains updates for any required manuals. 
• Monitor daily deposits and reconciliations. 
• Completes special projects that may require defining problems, determining work sequence and summarizing findings. 
• When necessary collects and provides statistics to administration. 
• Follows established standards, policies and procedures. 
• Review accounts assigned to bad debt, whether in collections or if payments have been received and contact collection agency with updates. 
• Provides oversight to ensure charges for services rendered are properly entered in to the computer billing system. 
• Knowledgeable of medical billing practices. 
• Knowledgeable of Level I Healthcare Common Procedure Coding Systems (HCPCS) comprised of Current Procedural Terminology (CPT-4) and International Classification of Diseases (ICD) codes. 
• Knowledgeable of Medicare, Medicaid, Insurance Managed Care Plans and Workmen’s Compensation. 
• Manages Accounts Receivable effectively. 
• Responsible and/or provides oversight to the Indigent Care program. 
• Monitors receivable for incorrect contractual allowances, non-covered services and payments recorded on incorrect date of service. Prepares adjustment report when necessary for approval. 
• Monitors credit balances, prepares a request for refunds as needed and presents for approval. 
• Prepares and presents for approval Quarterly Medicare Credit Balance Report. 
• Develops and maintains positive, effective working relationships with other employees, supervisors and medical providers. 
• Reads and monitors bulletins from plans subscribed to for changes and updates in claims submission. 
• Fields and answers questions from patients regarding account/s. Replies to any inquiries in a timely manner. 
• Ensure strict confidentiality of financial and medical records under HIPAA, HIPAA Security laws and hospital/clinic policies and procedures. 
• Communicates clearly written and oral medical information to professional practitioners and/or the general public. 
• Supervises the distribution of the mail to appropriate personnel in an accurate and timely manner. 
• Projects a positive attitude toward job responsibilities, medical providers, co-workers and administration. 
• Motivated and independent to work and organize so that all job functions are completed appropriately. 
• Responsible for the implementation of and compliance with all safety policies and procedures within the department. 
• Attend continuing education classes as requested or required. 
• Attends meetings as required. 
• Miscellaneous duties as assigned requested or required. 

EDUCATION and/or EXPERIENCE: 

• High School Diploma/GED 
• 1 - 2 years management experience, preferred 
• 1 – 2 years experience in bookkeeping, clerical and applicable computer training 
• Prior medical office management, preferred 
• Customer Service trained or experience, preferred 

LANGUAGE/READING SKILLS: 

Communicate verbally and in writing in English. 

Additional language of Spanish preferred. 

MATHEMATICAL SKILLS: 

Must be proficient at mathematical and statistical calculations. 

REASONING ABILITY:

Employee responds to unusual or varied situations that are not covered by existing standards, procedures and precedents.

WORK ENVIRONMENT:

Employee is regularly required to stand, walk, sit, ascend and descend stairs, possess ability to handle, finger or feel objects, tools or controls; reach with hands and arms. 

Employee must frequently be able to lift 25 pounds from the floor to waist level and may occasionally be required to lift 50 pounds. Specific vision abilities include close vision and the ability to clearly focus vision.