Business Office Manager

Job description

Open Until Filled Summary: The Business Office Manager is responsible for directing and overseeing the clinic’s business operations to ensure efficient administrative, financial, and patient support services. This position manages revenue cycle functions, third-party billing, Purchased/Referred Care (PRC), patient registration, health information management, transportation coordination, and purchasing processes that support daily clinic operations. The Business Office Manager provides leadership and overall support to business office staff while working collaboratively with clinical providers, administrative departments, and senior leadership to improve operational workflows, maintain regulatory compliance, and ensure quality patient service delivery. This position is responsible for ensuring compliance with the Health Insurance Portability and Accountability Act (HIPAA), Indian Health Service (IHS) requirements, third-party payer regulations, and Tribal policies. The Business Office Manager also oversees purchasing coordination by ensuring purchase orders, check requests, and related financial submissions are completed in accordance with approved budget line items and internal approval processes to support timely vendor payments and operational needs. Responsibilities: Provide leadership, supervision, training, scheduling, performance evaluation, and overall operational support for business office staff, including PRC, transportation, patient registration, billing, and medical records personnel. Ensure overall staff support by assisting employees with operational needs, workflow challenges, resource coordination, and problem-solving to maintain efficient day-to-day clinic operations. Serve as a resource to administrative staff, clinical staff, healthcare providers, and contractors by providing ongoing support related to business office processes, Electronic Health Record (EHR) systems, and operational procedures. Oversee daily business office operations to ensure efficient workflows, timely service delivery, and operational accountability. Develop, implement, and monitor departmental policies, procedures, and internal controls to improve operational efficiency and regulatory compliance. Collaborate with clinic leadership to identify workflow gaps and implement process improvements that enhance patient services and operational performance. Oversee all billing operations to ensure timely and accurate claims submission, collections, payment posting, and accounts receivable management. Monitor third-party billing functions, including Medicare, Medicaid, private insurance, contract health reimbursements, and other payer sources. Ensure proper coding, billing compliance, documentation requirements, and payer audit readiness. Prepare financial and operational reports related to billing performance, reimbursement trends, collections, and accounts receivable. Identify opportunities to improve revenue capture and reduce claim denials. Assist in managing the Purchased/Referred Care (PRC) program, including, Patient eligibility, determinations, Residency verification, Authorizations, Documentation review, Appeals coordination, Specialty provider coordination. Ensure PRC claims are processed accurately and within required deadlines. Maintain compliance with Indian Health Service (IHS), Catastrophic Health Emergency Fund (CHEF), and PRC program requirements. Oversee patient registration processes to ensure accurate demographic data collection, insurance verification, consent forms, and documentation scanning into the EHR. Ensure proper maintenance, security, and confidentiality of patient records. Oversee Health Information Management (HIM) functions, including Release of Information (ROI) requests, ensuring proper authorization and compliance requirements are met. Ensure accurate patient reporting data is available for clinical reporting requirements and internal performance measures. Serve as the clinic’s HIPAA Privacy Officer. Ensure staff compliance with HIPAA Privacy and Security regulations. Maintain HIPAA policies and procedures. Ensure timely completion of required HIPAA training for staff. Monitor compliance related to protected health information and patient confidentiality standards. Collaborate with clinical and administrative staff to coordinate transportation requests for patients receiving medical services. Ensure transportation services support continuity of care and patient access to healthcare services. Submit all purchase orders into the Tribe’s financial system in accordance with approved budget line items for review and approval by the Health Director. Work collaboratively with senior staff to prepare and submit purchase orders, check requests, invoices, and related financial documentation. Monitor purchasing requests to ensure expenditure aligns with approved budgets and funding sources. Coordinate with finance staff to ensure payments are processed timely and vendors are paid accordingly. Maintain accurate purchasing documentation and records for audit and compliance purposes. Participate in annual budget development and departmental financial planning. Monitor departmental expenditures and assist leadership in budget forecasting. Provide recommendations to improve fiscal efficiency and resource allocation. Ensure compliance with Tribal policies, federal regulations, state regulations, healthcare regulations, and payer requirements. Represent the clinic in meetings with vendors, regulatory agencies, healthcare partners, and external stakeholders as needed. Perform other duties as assigned. Knowledge, Skills and Abilities: Strong knowledge of healthcare finance, revenue cycle operations, and tribal-specific reimbursement systems. Demonstrated leadership, analytical, and operational expertise required to effectively manage functions within a complex healthcare environment. Ability to work collaboratively across departments to evaluate workflows, identify operational gaps, and implement efficiency improvements. Strong understanding of patient confidentiality requirements and the secure handling of protected health information and patient records. Knowledge of healthcare billing regulations, reimbursement methodologies, and payer requirements. Strong organizational skills with the ability to manage multiple priorities and deadlines. Proficient in Electronic Health Record (EHR) systems, billing software, and financial systems. Strong written and verbal communication skills. Knowledge of Indian Health Service (IHS) regulations, Catastrophic Health Emergency Fund (CHEF), and PRC guidelines. Qualifications: Bachelor’s degree in business administration, Healthcare Administration, Finance, or a related field or an equivalent combination of education and experience that demonstrates the knowledge, skills, and abilities required to perform the position. Certified Professional Coder (CPC), Certified Professional Biller (CPB), or Certified Billing and Coding Specialist (CBCS) preferred. Four (4) years of experience working in Tribal health systems, Indian Health Service (IHS), Federally Qualified Health Centers (FQHC), or similar healthcare environments. Two (2) years of experience with Medicaid/Medicare billing, managed care, and payer audits. Must be able to obtain HIPAA certification. Must possess a valid Nevada Driver’s License required. Must pass pre-employment drug screening. Tribal Council Approved: May 13, 2026