JOB SUMMARY: $43,888 - $55,515 Annually M-F
The primary purpose of the Business Office Manager position is to evaluate and monitor the financial viability of
all referrals to Vanguard facilities, communicate financial and benefit information to residents and/or family
members, collect patient liabilities, copays, and other private pay charges upon admission and on an ongoing
basis, monitor the application and approval status of all Medicaid Pending residents, administer the resident
trust, maintain and report resident demographic, financial, and census data, assist the Centralized Billing Office
with charge capture activities for ancillary and other charges.
JOB DUTIES & RESPONSIBILI TIES:
Res ident Financial Functions
- Receive, review and evaluate all referrals for potential admission to a Vanguard facility, to determine
financial eligibility and viability.
- Review the common working file for Medicare-funded referrals to determine Medicare eligibility.
- Communicate financial viability to the Admissions Coordinator and discuss medications, equipment
and other special needs that impact cost of care.
- Prepare a cost projection for all financially viable referrals to Vanguard facilities, based on
determination of clinical and other needs (as identified by the Admissions Coordinator).
- Determine Medicare Part B coverage prior to the initiation of therapy services by the therapy vendor.
- For all referrals who will convert to Medicaid during length of stay, determine whether or not the
Medicaid application process has been initiated; Work with the referral source and family to initiate the
process if not yet begun. Review the state’s home page to determine whether or not the referral
currently has property or has recently transferred assets which would prevent Medicaid eligibility. Initiate
Medicaid-pending tracking log.
- Ensure the timely submission of all required assessments and documentation related to Medicaid
eligibility (PAE, PASARR, DMAS, FL-2, etc.). Ensure that these forms are updated and resubmitted as
necessary.
- Determine the need for and obtain pre-authorization for managed care payers including those for
primary, secondary, and ancillary services.
- Ensure that required ongoing authorizations are obtained by facility clinical staff.
- Collect all upfront monies due upon admission.
- Ensure the collection of all private pay balances as they become due and payable.
- Ensure that resident admission contracts are signed and appropriately filed.
- Ensure appropriate supporting documents are scanned into the electronic medical record (consent to
treat, common working file (CWF), copies of insurance cards, etc.)
- Verifies and records specific ancillary charge information as directed by the corporate office.
Census Management Functions:
- Enter complete and accurate financial, demographic, and census data into the electronic medical
record (PCC).
- Record any census changes (admission, readmission, discharge, bed hold, room change, payer
change, liability change, level of care change, etc.).
- Reconcile the recorded census to the midnight census each business day by 10 am CST.
Resident Trust Management
- Administers the resident trust software (RFMS) according to established policies and procedures.
- Completes resident trust enrollment forms with new residents. Encourages participation by all residents
and constantly strives to increase enrollment.
- Ensures that direct deposit and liability data are updated in RFMS timely and that the information there
matches the information in PCC.
- Reconciles the resident trust accounts on a monthly basis, resolving any reconciling items within 30 days.
- Ensures that the resident trust fund petty cash box is balanced at all times.
- Monitors the trust balance to ensure that the established surety bond is adequate to cover the account
balance in accordance with state requirements.
Committee Functions
- Attends the facility daily stand-up meeting to update facility staff and leadership of issues related to
resident financial matters, bed control and census, etc.
- Attends the weekly PPS meeting to ensure that information from those meetings is shared with the
corporate billing staff.
- Serves on various committees of the company to review financial and/or operational policies and
procedures and provide written reports as directed by the Administrator, Director of Revenue Cycle, the
Chief Financial Officer and/or the Director of Operations.
JOB REQUIREMENTS:
Education
- Must possess an Associate Degree in Accounting or Business Administration from an accredited college
or university or the equivalent experience in a related setting.
Experience
- Must have a minimum of one (1) year of business office, admissions, or other related experience in a
skilled nursing setting.
