Medicaid Specialist/Business Office Manager

Outcome HC; Phillipsburg (NJ); On-site; USD 65,000 - 90,000; Full time

Job summary

Country Arch Care Center in Union Township, New Jersey, is seeking a highly organized Business Office Manager to oversee day-to-day financial, administrative, and HR functions within the business office.

The role requires coordinating Medicaid applications and billing, managing resident financial accounts, and producing routine financial reports. You will work with Admissions, Social Services, Nursing, and Clinical teams to ensure compliant and timely Medicaid processes.

Qualifications

• Experience coordinating Medicaid applications and eligibility for residents.
• Strong financial record-keeping and reporting skills.
• Supervisory experience with business office staff a plus.
• Ability to liaise with Admissions, Social Services, Nursing, and Clinical teams.

Responsibilities

• Manage Medicaid application and eligibility process for residents.
• Obtain and verify financial and personal documentation for Medicaid.
• Communicate with residents, families, attorneys, and government agencies on Medicaid matters.
• Track Medicaid applications, approvals, denials, spend-downs, and required documents.
• Submit Medicaid claims and follow up on unpaid or denied claims.
• Maintain resident financial accounts including Medicaid and private-pay balances.
• Prepare census, billing, accounts receivable, and collection reports.
• Monitor balances and work with residents/families to resolve issues.
• Ensure timely Medicaid redeterminations and documentation.
• Coordinate with various departments to obtain eligibility information.
• Maintain records in line with policies and Medicaid regulations.
• Assist with audits and provide requested Medicaid documentation.
• Monitor changes in Medicaid regulations and reimbursement rules.
• Maintain confidentiality of resident financial information.
• Supervise or coordinate business office staff as applicable.
• Assist Administrator with financial reporting and budgeting.

Skills

Medicaid management

Finance reporting

Team supervision

Cross-functional coordination

Job description

Business Office Manager

About the Role:

We are seeking a highly motivated and organized Business Office Manager to join our team at Country Arch Care Center in Union Township, New Jersey. As a member of our administrative team, you will be responsible for overseeing the day-to-day operations of our business office, ensuring efficient and effective management of financial, administrative, and HR functions.

Responsibilities:

• Manage and coordinate the Medicaid application and eligibility process for current and prospective residents.
• Obtain, verify, and maintain required financial and personal documentation for Medicaid applications and recertifications.
• Communicate with residents, responsible parties, family members, attorneys, and government agencies regarding Medicaid status and requirements.
• Track Medicaid applications, pending cases, approvals, denials, spend-downs, and requests for additional documentation.
• Submit Medicaid claims and follow up on unpaid, denied, or rejected claims.
• Maintain accurate resident financial accounts, including private-pay balances, Medicaid payments, insurance payments, and other sources of reimbursement.
• Prepare and maintain census, billing, accounts receivable, and collection reports.
• Monitor outstanding balances and work with residents and responsible parties to resolve payment issues.
• Ensure timely completion of Medicaid redeterminations and required documentation.
• Coordinate with the Admissions, Social Services, Nursing, and Clinical teams to obtain information necessary for Medicaid eligibility and billing.
• Maintain accurate records in accordance with facility policies, Medicaid regulations, and applicable federal and state requirements.
• Assist with audits and provide requested financial and Medicaid documentation.
• Monitor changes in Medicaid regulations, reimbursement requirements, and eligibility guidelines.
• Maintain confidentiality of resident financial and personal information.
• Supervise or coordinate business office staff, as applicable.
• Assist the Administrator with financial reporting, budgeting, collections, and other business office functions.
• Perform other duties as assigned by the Administrator or Director of Finance.