Job Summary

The Business Office Manager is responsible for the overall leadership, coordination, and performance of the Business Office functions to ensure accurate financial operations, regulatory compliance, efficient revenue cycle management, and timely reporting. This position oversees patient access, scheduling, insurance verification, medical records, billing, collections, and accounts receivable functions while supporting the facility's financial objectives and operational goals.

The Business Office Manager ensures all business office operations are functioning accurately and efficiently to support cash flow, maximize reimbursement, maintain compliance, and generate meaningful management reports. The position also oversees the maintenance and security of medical records in accordance with all applicable legal and regulatory requirements.

Reports To

• Facility Administrator
• Director of Business Office Services

Supervises

• Receptionist / Medical Records Clerk
• Biller / Collector
• Scheduler
• Other assigned business office personnel

Qualifications

Education

• Bachelor’s degree in business administration, Healthcare Administration, Accounting, Finance, or related field preferred.
• Equivalent combination of education and experience may be considered.

Experience

• Minimum of two (2) years of business office management experience in a healthcare setting.
• Ambulatory Surgery Center (ASC), surgical hospital, or physician practice experience preferred.
• Revenue cycle management and healthcare reimbursement experience required.

Knowledge, Skills, and Abilities

• Strong understanding of healthcare revenue cycle operations.
• Working knowledge of Medicare, Medicaid, commercial insurance reimbursement methodologies, and payer contracting.
• Knowledge of HIPAA, CMS regulations, OIG guidelines, and healthcare compliance requirements.
• Advanced proficiency in Microsoft Office Suite, including Excel, Word, and Outlook.
• Excellent analytical, organizational, and problem-solving skills.
• Strong written and verbal communication abilities.
• Ability to lead teams, manage priorities, and meet deadlines in a fast-paced healthcare environment.

Essential Duties and Responsibilities

Revenue Cycle Management

• Direct and oversee all revenue cycle functions including registration, scheduling, insurance verification, billing, collections, payment posting, accounts receivable follow-up, and denial management.
• Monitor and improve key revenue cycle performance indicators, including:
  • Net Collection Rate
  • Accounts Payable
  • Initial Denial Rate
  • Aged Accounts Receivable
  • Cash Collections
  • Bad Debt
  • Days in Accounts Receivable
  • Contractual Adjustment Accuracy
  • Revenue Cycle Productivity Metrics
• Prepare and distribute monthly revenue cycle reports and analyses.
• Manage daily sales reporting and cash reconciliation processes.
• Support case costing analysis and budget variance reporting.
• Coordinate accounts payable activities with materials management and other departments as needed.
• Review reimbursement trends and identify underpayments or payment discrepancies.
• Oversee denial management processes and appeal activities.
• Collaborate with corporate revenue cycle teams to resolve billing and reimbursement issues.
• Develop action plans to improve collections, reduce denials, and optimize cash flow.

Contract Management and Reimbursement Oversight

• Maintain knowledge of payer contracts and reimbursement methodologies.
• Review contractual adjustment trends and reimbursement performance monthly.
• Validate payer contract terms loaded within billing systems.
• Identify contract modeling issues and reimbursement variances.
• Assist with implementation and maintenance of new payer contracts.
• Escalate reimbursement discrepancies and payer concerns to leadership.
• Support payer negotiations through reimbursement analysis and reporting.

Financial Reporting and Business Operations

• Ensure timely and accurate completion of month-end business office reporting.
• Assist leadership with budgeting, forecasting, and financial analysis.
• Monitor departmental productivity and operational performance.
• Analyze financial trends and recommend process improvements.
• Ensure appropriate internal controls are maintained for cash handling and financial transactions.
• Support facility financial goals through operational efficiency and revenue optimization initiatives.

Compliance and Audit Oversight

• Ensure compliance with Medicare, Medicaid, HIPAA, OIG, and commercial payer requirements.
• Maintain compliance with facility policies and revenue cycle procedures.
• Participate in internal and external audits.
• Assist with accreditation surveys and regulatory inspections.
• Ensure proper maintenance, retention, confidentiality, and release of medical records in accordance with legal and regulatory standards.
• Monitor compliance with medical records documentation requirements.

Technology and Systems Management

• Serve as facility super-user and subject matter expert for:
  • HST Pathways
  • Waystar
  • Surgical Notes
  • Clariti
  • Other business office software platforms
• Assist with system upgrades, testing, implementation projects, and workflow enhancements.
• Ensure data integrity and reporting accuracy across all systems.
• Train staff on business office technologies and process improvements.
• Identify opportunities to leverage technology to improve efficiency and reporting capabilities.

Leadership and Staff Management

• Supervise all business office personnel, including:
  • Scheduling
  • Registration
  • Insurance Verification
  • Medical Records
  • Billing
  • Collections
  • Other assigned staff
• Recruit, train, mentor, and evaluate business office employees.
• Conduct performance evaluations and coaching sessions.
• Promote employee engagement, accountability, and professional development.
• Ensure adequate staffing and workflow coverage.
• Participate in facility leadership meetings and strategic planning initiatives.
• Support organizational goals and operational improvement projects.
• Serve as Administrator designee when requested.
• Foster positive collaboration between clinical departments and business office personnel.

Physical Requirements

• Ability to sit, stand, walk, bend, and lift up to 25 pounds occasionally.
• Ability to operate standard office equipment and computer systems.
• Ability to perform prolonged computer work and data analysis.

Performance Expectations

The Business Office Manager is expected to:

• Maintain high standards of accuracy, compliance, and professionalism.
• Achieve established revenue cycle and financial performance targets.
• Support continuous process improvement initiatives.
• Demonstrate leadership, accountability, and teamwork.
• Contribute to the overall success and financial health of the facility.

FLSA Status: Exempt

Position Classification: Management

Work Environment: Ambulatory Surgery Center / Surgical Hospital / Outpatient Healthcare Facility

1. Responsible for daily cash management Receives and accounts for all cash received in accordance with Facility Policy.
   • Disburses and ensures disbursement of cash in accordance with Facility

1. Reviews insurance contracts to assure accurate contractual reimbursement and collections and adherence to Business Office policies and procedures.
   • Maintains good working relationships with insurance
   • Maintains good working knowledge of insurance payors reimbursement requirements and updates Business Office personnel on an as needed
2. Maintains inventory of forms and office

1. Resolves problems with billings, collections, and medical
2. Prepares analysis reports for annual outside

1. Maintains all office computer systems and
   • Responsible for verification that the backup process is maintained
   • Ensures that all staff personnel adhere to the Facility’s Integrity of Data Systems

Policy.

• Ensures all computer system warranties, upgrades and maintenance contracts are

1. Reviews all business procedures and recommends adjustments to Facility CEO on an as needed basis.
2. Monitors fee schedule and submits suggested changes to Facility
   • Periodically reviews computerized fee schedule and that all changes to fee schedule, once approved have been implemented in computer system
   • Ensures that yearly coding changes have been made in the computer CPT data
3. Assists Facility in development of annual

1. Assumes any other responsibilities that may be assigned from Administration on an as needed basis.

1. Ensures daily that patients and their relatives are dealt with in a professional and courteous manner by the Business Office personnel.

PHYSICAL DEMANDS

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools, or controls; and to reach with hands and arms. The employee is occasionally required to walk. Specific vision abilities required by this job include close vision and the ability to adjust focus.
• The employee must occasionally lift and/or move up to 25