Business Office Manager: Critical Access Hospital (On-site Required)

Pagosa Springs Medical Center•Pagosa Springs, CO

4d•$79,456 - $99,320•Onsite

About The Position

Pagosa Springs Medical Center (PSMC) is seeking an experienced and collaborative Manager: Business Office to lead our Patient Financial Services Business Office. The Business Office Manager is responsible for the overall management of Business Office operations, ensuring timely and accurate billing, regulatory compliance, staff development, and achievement of organizational cash collection goals. This position oversees financial activities related to PSMC's hospital, clinic, and ambulance services, including patient billing, accounts receivable management, payment posting, denial management, collections, financial assistance processing, and reimbursement activities. This is a hands-on leadership opportunity for an experienced healthcare revenue cycle professional who combines strong technical knowledge of billing and reimbursement with effective leadership, analytical thinking, accountability, and a commitment to continuous improvement. This position is required to work on-site at Pagosa Springs Medical Center in Pagosa Springs, Colorado. Remote and hybrid work arrangements are not available for this role.

Requirements

Associate's degree in business, healthcare administration, accounting, finance, or another related field
Minimum of five (5) years of healthcare billing and accounts receivable experience
Minimum of three (3) years of supervisory or management experience in healthcare billing and accounts receivable
Thorough knowledge of healthcare billing and reimbursement processes
Strong understanding of Medicare, Medicaid, commercial insurance, and self-pay reimbursement
Knowledge of UB-04 and CMS-1500 claim processing
Strong understanding of accounts receivable and denial management
Strong leadership and employee-development abilities
Excellent analytical, organizational, and problem-solving skills
Excellent written and verbal communication skills
Proficiency with Microsoft Office and healthcare billing systems
Ability to effectively manage multiple priorities, projects, deadlines, and frequent interruptions
Ability to work independently while collaborating effectively across departments
Strong critical-thinking skills and sound professional judgment
Is an experienced healthcare revenue cycle professional who understands the full lifecycle of billing and accounts receivable
Has demonstrated success leading, coaching, and developing healthcare Business Office teams
Understands the importance of accurate, compliant, and timely billing
Uses data and key performance indicators to identify problems and drive measurable improvement
Is comfortable addressing denials, aging accounts, reimbursement variances, workflow inefficiencies, and compliance concerns
Balances financial performance with excellent patient service
Holds themselves and their team accountable while maintaining a respectful and supportive work environment
Communicates clearly and collaborates effectively across departments and leadership levels
Is comfortable leading change and implementing new workflows, technology, and processes
Demonstrates initiative, integrity, sound judgment, and strong follow-through
Is able to work on-site at Pagosa Springs Medical Center on a full-time basis
Embodies PSMC's WISER values of Wholeness, Integrity, Stewardship, Excellence, and Respect

Nice To Haves

Bachelor's degree in healthcare administration, business administration, accounting, finance, or another related field
Healthcare billing and accounts receivable management experience in a Critical Access Hospital
Rural Health Clinic billing experience
Ambulance billing experience
Knowledge and experience with Oracle Health (Cerner) CommunityWorks

Responsibilities

Oversee day-to-day Business Office operations, including patient billing, accounts receivable, payment posting, denial management, collections, financial assistance, and reimbursement.
Ensure timely and accurate billing for Critical Access Hospital inpatient and outpatient services, Rural Health Clinic services, and ambulance services.
Monitor claim submission timeliness and billing accuracy.
Ensure claims are submitted in accordance with federal, state, payer, and organizational requirements.
Monitor accounts receivable aging and develop strategies to reduce outstanding balances.
Oversee the resolution of claim edits, rejections, denials, underpayments, and credit balances.
Ensure timely appeals, corrections, and rebilling efforts.
Monitor accurate and timely posting of payments and contractual adjustments.
Review reimbursement trends and identify payment variances.
Monitor Medicare, Medicaid, commercial insurance, and self-pay accounts.
Support achievement of organizational cash collection and revenue cycle performance goals.
Ensure compliance with applicable Rural Health Clinic billing and reimbursement requirements.
Monitor RHC encounter billing and reimbursement accuracy.
Review claims for compliance with Medicare and Medicaid requirements.
Assist with implementation of regulatory and reimbursement changes affecting RHC services.
Oversee ambulance billing and reimbursement processes.
Ensure documentation supports billing and medical necessity requirements.
Monitor denied and underpaid ambulance claims and coordinate corrective action.
Collaborate with ambulance leadership to improve documentation, charge capture, and reimbursement processes.
Monitor accounts receivable performance and aging trends.
Develop strategies to improve collection performance and reduce outstanding balances.
Monitor denial trends and identify root causes.
Coordinate timely follow-up, appeals, rebilling, and corrective action.
Identify opportunities to improve clean claim rates and reduce preventable denials.
Monitor reimbursement and underpayment trends.
Support achievement of annual organizational cash collection goals.
Promote timely resolution of outstanding patient and payer balances.
Administer hospital financial assistance and charity care programs.
Ensure timely and accurate processing of applications and supporting documentation.
Oversee patient statements, payment plans, and collection processes.
Ensure compliance with applicable financial assistance and collection requirements.
Support professional, respectful, and patient-centered financial interactions.
Collaborate with Finance regarding cash collections and reconciliation processes.
Provide leadership and supervision to Business Office staff, including the Patient Financial Services Supervisor and Customer Service Lead.
Establish clear performance expectations and departmental standards.
Coach, mentor, recognize, and develop employees.
Hold team members accountable in a fair, consistent, and respectful manner.
Conduct performance evaluations and participate in performance improvement activities.
Develop departmental goals, productivity expectations, and quality standards.
Ensure adequate staffing and workflow coverage.
Support recruitment, interviewing, onboarding, training, development, and retention.
Promote cross-training and professional development opportunities.
Conduct regular department meetings and maintain effective communication with staff.
Foster a positive, collaborative, accountable, and high-performing work environment.
Monitor and improve key Business Office performance indicators, including: Days in accounts receivable, Clean claim rate, Denial rates, Timely resolution of outstanding accounts, Cash collection performance, Audit and compliance outcomes, Staff productivity and engagement.
Use data, reporting, and trend analysis to identify opportunities for improvement and implement changes through workflow development, education, training, technology, and process redesign.
Maintain compliance with Medicare, Medicaid, HIPAA, payer requirements, and organizational policies.
Ensure department operations comply with applicable federal, state, and local requirements.
Assist with internal and external audits.
Develop, update, and implement Business Office policies and procedures.
Educate staff regarding billing regulations, reimbursement requirements, and compliance expectations.
Maintain department readiness for applicable regulatory and licensing surveys.
Investigate and appropriately report evidence of potential fraud or abuse.
Monitor regulatory and reimbursement changes and implement necessary operational changes.
Develop and manage departmental budgets.
Monitor budget performance and variances and initiate corrective action when appropriate.
Forecast staffing, technology, operational, and capital needs.
Develop departmental strategic and operational goals aligned with PSMC's mission and strategic plan.
Prepare, analyze, and present departmental statistics and reports.
Participate in contract negotiations and maintain current departmental contracts.
Lead projects from planning and implementation through tracking and completion.
Collaborate with Informatics to improve EHR and revenue cycle workflows.
Use data and technology to identify trends, improve efficiency, and support informed decision-making.