Skilled Nursing Regional Business Office Manager (RBOM)

Avir Trilogy; San Antonio (TX); On-site; USD 90,000 - 130,000; Full time

Job summary

Avir Trilogy is seeking a Regional Business Office Manager to lead the business office operations for multiple skilled nursing facilities across Texas. You will partner with executives to ensure accurate, compliant and efficient financial and administrative operations, while driving reimbursement optimization.

The role requires strong leadership, deep knowledge of Medicare/Medicaid, and hands-on experience with billing, audits, and records management across multi-site operations.

Qualifications

• Minimum of five years of progressive business office leadership experience in skilled nursing or long-term care.
• Experience with Medicare, Medicaid, managed care, private pay billing and reimbursement.
• Strong accounting, bookkeeping, AR management and financial reporting knowledge.
• Audits and regulatory readiness experience.
• Excellent communication with executives, staff, residents, and families.

Responsibilities

• Oversee business office operations across multiple facilities.
• Monitor accounts receivable, cash collections, aging and reimbursement processes.
• Review financial reports, identify trends, and improve revenue cycle performance.
• Assist with budgets, financial controls and operational efficiencies.
• Ensure timely billing for Medicare/Medicaid/Private pay; collaborate with corporate teams.
• Mentor and develop Business Office Managers and staff.
• Ensure medical records processes compliant with regulations.

Skills

Leadership

Communication

Analytical thinking

Problem solving

Organizational skills

Coaching/Mentoring

Tools

Electronic health records (EHR)

Billing software

Microsoft Office

Financial management software

Job description

Regional Business Office Manager – Skilled Nursing Facilities (Texas)

The Regional Business Office Manager provides operational leadership and oversight for the business office functions across multiple skilled nursing facilities throughout Texas. This position partners with Executive Directors, Business Office Managers, and regional leadership to ensure the financial and administrative operations of each community are accurate, compliant, efficient, and aligned with organizational goals.

Essential Responsibilities

Financial Operations

• Provide oversight and support for business office operations across multiple skilled nursing facilities.
• Monitor and improve accounts receivable performance, cash collections, aging, and reimbursement processes.

• Review financial reports, identify trends, and recommend strategies to improve revenue cycle performance.
• Ensure accurate bookkeeping practices, month-end close activities, resident trust accounting, and financial record maintenance.
• Assist facilities with budget monitoring, financial controls, and operational efficiencies.
• Ensure timely and accurate billing for Medicare, Medicaid, managed care, private pay, and other payer sources.
• Collaborate with corporate finance and reimbursement teams to resolve complex billing and payment issues.

Business Office Leadership

• Mentor, train, and develop Business Office Managers and administrative staff.

Medical Records Oversight

• Provide oversight of medical records processes to ensure documentation is accurate, complete, and maintained in accordance with federal, state, and organizational requirements.
• Monitor compliance with record retention policies, privacy regulations, and health information management standards.
• Partner with clinical leadership to support accurate documentation that facilitates reimbursement and regulatory compliance.

Qualifications

• Minimum of five years of progressive business office leadership experience in skilled nursing or long-term care.
• Multi-facility or regional healthcare management experience preferred.
• Comprehensive knowledge of Medicare, Medicaid, managed care, private pay billing, collections, and reimbursement processes.
• Strong understanding of accounting principles, bookkeeping, accounts receivable management, and financial reporting.
• Knowledge of medical records management and healthcare documentation requirements.
• Experience preparing facilities for financial audits and regulatory reviews.
• Excellent analytical, organizational, and problem-solving skills.
• Strong leadership and coaching abilities with experience mentoring business office staff.
• Exceptional verbal and written communication skills with the ability to effectively communicate with executive leadership, facility teams, residents, and families.
• Proficiency with electronic health records, healthcare billing systems, Microsoft Office, and financial management software.

Travel Requirements

• Ability to travel extensively throughout Texas to support assigned skilled nursing facilities.
• Overnight travel may be required based on business needs.
• Valid driver's license and reliable transportation required.

Physical Requirements

• Ability to travel frequently by automobile and, when necessary, by air.
• Ability to move throughout healthcare facilities during operational reviews and audits.
• Ability to sit, stand, and work at a computer for extended periods.
• Ability to lift and transport materials weighing up to 25 pounds.