A. BASIC PURPOSE

The Business Manager coordinates and manages all office, medical records and business/financial affairs, and other operational activities related to the administration of the office by performing the accounts receivable (AR) and accounts payable (AP) duties including: accurate and timely completion and submission of the billing, collections, and management of the computer information system for billing of Medicare, Medicaid and other third party payers both electronically and on paper. Oversees medical records functions and assist with billing management and oversight of the human resource records.

B. PRIMARY RESPONSIBILITIES

Office Management
1. Prepares reports on activities as required.
2. Assists with orientation of new employees and inservices by keeping records of attendance, copying and distributing materials and other relevant duties.
3. Performs office management and processes including office supplies, phone answering, office machine operations, organization and required content of files, keys/access for physical security, etc.
4. Maintains files including personnel and medical records, and maintains knowledge of legal and regulatory requirements including professional licenses, background check requirements, etc.
5. Files all clinical documentation, i.e., verbal orders, plans of care, logs and notes in medical records on a daily basis.
6. Maintains inventory of office and medical supplies by checking stock to determine inventory level and anticipated supply needs. Places orders for supplies and verifies receipt of supplies. Negotiates with vendors to ensure best price and service is obtained.
7. Maintains inventory of admission packets and forms by checking stock to determine inventory level and anticipated supply needs. Copies and/or orders necessary documents to ensure availability of the packets.
8. Forwards, via fax, verbal orders and plans of care to physician offices for signature; maintains a tracking process of items that are sent, signed and received as needed, and resends.
9. Ensures timely return of ADRs, verbal orders and plans of care from physician per state and federal guideline timeframes. This includes placing a follow-up phone call to the physician’s office, if necessary, and documenting response of inquiry in the tracking tool/log.
10. Oversees the management of the human resource files including but not limited to background checks, reference checks, verification of licensure, drug testing as applicable, arranging for medical screening including TB, hepatitis and medical examinations, running social security verifications and maintaining all documentation required in the personnel files.

Accounts Receivable
1. Accurately enters patient/client billing data, OASIS, visit charges, fee for service charges, and verifies discharge and admission data.
2. Coordinates, reviews, and analyzes documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing.
3. Coordinates, reviews and analyzes accounts receivable tracking tools and maintains accounts receivable and accounts payable files in order to ensure accurate and timely claim submission and to prevent lost revenue.
4. Ensures patient eligibility is confirmed through insurance companies and the Medicare system, and that the necessary paperwork is accurate and submitted timely to prevent lost revenue.
5. Maintains tracking tools and data to ensure that all necessary information is secured for timely accurate payment. This includes eligibility, insurance verification, authorizations, certification and recertification as well as state required documentation for Medicaid.
6. Ensures that the appropriate payers have been identified and verified. This includes securing and reviewing the Medicare secondary payer questionnaire.
7. Assists in the preparation of monthly accounts receivable review reports in order to ensure accuracy and timely processing of claims billed.
8. Alerts appropriate management team members regarding late or missing documents required for billing.
9. Alerts the Administrator of seriously overdue accounts receivable.

General Guidelines
1. Adheres to the agency’s Code of Conduct, conducting all business activities in a professional and ethical manner.
2. Interacts with all staff, patients/clients, payers, and other customers in a positive fashion supporting the agency’s mission and vision.
3. Complies with the agency’s general orientation and to agency policies and procedures including confidentiality and HIPAA guidelines.
4. Maintains the confidentiality of patient/client and agency information at all times.
5. Ensures compliance with local, state and federal laws, and established agency policies and procedures.
6. Participates in staff meetings, department meetings, team meetings, briefings, inservices, committees and other related activities as needed.

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents will be requested to perform job-related tasks other than those stated in this description.

C. HUMAN RELATIONS

1. Must maintain a professional attitude and demeanor and be able to communicate effectively and relate courteously and cooperatively with patients, caregivers, colleagues, supervisor, co-workers and all others.
2. Must be able to demonstrate optimism, enthusiasm and willingness to work constructively with other health care team members and reflect concern for the well-being of patients and others.

D. PHYSICAL REQUIREMENTS (See Attached Physical Requirements Form)

1. This position requires the Business Manager to work primarily in an office environment where heating and air conditioning is controlled, but may require travel to other locations, meetings, and seminars, etc.
2. Visual/hearing ability must be sufficient to comprehend written/verbal communication and include excellent listening skills.
3. Must be able to deal effectively with stress.

E. EDUCATION AND EXPERIENCE

1. Education
a. Possesses a Bachelor's Degree from an accredited college or university or the equivalent, based on background and experience.
2. Experience
a. Minimum age requirement of 18.
b. At least two years’ experience in health care, preferably in home health or similar operation
c. Two to three years’ accounts receivable/billing experience in health or insurance fields in an institutional environment, preferably in home health, hospice or similar operation preferred.
d. Demonstrates excellent computer skills.
e. Possesses leadership skills: enjoys working with people, assertive, mature, approachable and open-minded.
3. Licensure, Registration, and/or Certification
a. Satisfactory references from employers and/or professional peers.
b. Satisfactory criminal background check.

I have read and understand the Business Manager job description. It has been reviewed and discussed with me and I have had the opportunity to ask questions regarding same.