Job Description: Business Office Manager

Department: Administration / Business Office
Setting: Skilled Nursing Facility (SNF)

Position Summary

The Business Office Manager is responsible for overseeing the financial and administrative operations of the skilled nursing facility, including resident billing, insurance verification, accounts receivable, collections, and financial recordkeeping. This role ensures accurate billing, timely reimbursement, compliance with facility policies, and effective communication with residents, families, insurance providers, and government agencies.

The ideal candidate will have at least one year of experience in a skilled nursing facility or a similar healthcare setting and a strong understanding of Medicare, Medicaid, managed care plans, private insurance, copayments, coinsurance, deductibles, private-pay accounts, and insurance coverage requirements.

Essential Duties and Responsibilities

• Manage daily business office operations, including resident accounts, billing, payment posting, and financial recordkeeping.

• Verify insurance eligibility, benefits, coverage limits, authorization requirements, and payer guidelines for Medicare, Medicaid, managed care, and private insurance plans.

• Maintain a working knowledge of Medicare and Medicaid coverage, resident financial responsibility, copayments, deductibles, coinsurance, and private-pay obligations.

• Prepare, review, and submit accurate resident bills and insurance claims in a timely manner.

• Monitor accounts receivable, track outstanding balances, follow up on unpaid claims, and resolve billing discrepancies or denials.

• Manage private-pay collections and resident responsibility balances while maintaining professionalism, confidentiality, and sensitivity when communicating with residents and families.

• Communicate with insurance companies, Medicaid agencies, residents, family members, and other responsible parties regarding coverage, billing questions, payment arrangements, and outstanding balances.

• Maintain accurate financial records, resident account documentation, insurance information, and supporting billing documentation.

• Review insurance policies and benefit details to determine coverage, exclusions, limitations, and potential out-of-pocket expenses.

• Coordinate with admissions, social services, clinical staff, and facility leadership to obtain required financial information and support accurate payer classification and billing.

• Assist with Medicaid applications, eligibility reviews, renewals, and follow-up on pending determinations, as applicable.

• Identify billing errors, investigate payment discrepancies, and work toward timely resolution of outstanding accounts.

• Ensure compliance with applicable regulations, payer requirements, facility policies, and confidentiality standards.

• Prepare financial reports, aging reports, collection summaries, and other business office reports as requested by facility leadership.

• Maintain organized resident financial files and respond to internal and external requests for billing documentation.

• Provide professional customer service and clear explanations of billing responsibilities, insurance coverage, and payment expectations.

Qualifications and Requirements

• Minimum of one year of experience in a skilled nursing facility (SNF), long-term care facility, or similar healthcare setting.

• Working knowledge of Medicare, Medicaid, managed care, commercial insurance, and other healthcare payer plans.

• Understanding of insurance verification, coverage policies, authorizations, copayments, coinsurance, deductibles, and private-pay collections.

• Experience with healthcare billing, accounts receivable, payment posting, collections, and claim follow-up.

• Familiarity with Medicaid eligibility and application processes is preferred.

• Proficiency in Microsoft Office and the ability to learn and use electronic billing and financial management systems.

• Strong organizational skills, attention to detail, time management, and problem-solving abilities.

• Excellent written and verbal communication skills.

• Ability to handle confidential financial and resident information appropriately.

• Ability to work independently, prioritize multiple responsibilities, and meet deadlines.

Preferred Qualifications

• Previous experience as a Business Office Manager, Business Office Assistant, Billing Specialist, or Accounts Receivable Specialist in a long-term care or healthcare environment.

• Experience with skilled nursing facility billing systems and payer-specific billing procedures.

• Knowledge of long-term care reimbursement, resident trust accounts, and financial admission processes, as applicable.

Key Competencies

• Accuracy and attention to detail

• Financial accountability and follow-through

• Professional communication and customer service

• Confidentiality and ethical handling of financial information

• Organization, time management, and prioritization

• Teamwork and collaboration across departments

Work Environment

This position operates in a skilled nursing facility and requires regular interaction with residents, family members, facility staff, insurance representatives, and government agencies. The Business Office Manager must be able to manage competing priorities while maintaining accurate records, meeting deadlines, and providing professional service.

Equal Employment Opportunity

The facility is committed to providing equal employment opportunities in accordance with applicable federal, state, and local laws.