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

Manager: Business Office

Department: Patient Financial Services
Status: Full-Time | 1.0 FTE
FLSA Status: Exempt
Schedule: 40+ hours/week
Reports To: Director: Revenue Cycle
Location: Pagosa Springs Medical Center – Pagosa Springs, Colorado
Work Arrangement:On-Site Required | Not Eligible for Remote or Hybrid Work

🏥Position Highlight

Lead the Business Office operations that support the financial health of Pagosa Springs Medical Center. This on-site leadership role offers the opportunity to develop a high-performing team, strengthen revenue cycle performance, and oversee billing and accounts receivable operations across hospital, clinic, and ambulance services.

Position Summary

Pagosa Springs Medical Center (PSMC) is seeking an experienced and collaborativeManager: Business Office to lead our Patient Financial Services Business Office.

The Business Office Manager is responsible for the overall management of Business Office operations, ensuringtimely 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.

Why Join PSMC?

• Lead a critical component of the revenue cycle for a rural Critical Access Hospital
• Oversee Business Office operations acrosshospital, Rural Health Clinic, and ambulance services
• Develop, mentor, and support a team of healthcare revenue cycle professionals
• Directly influence accounts receivable performance, cash collections, denial management, and reimbursement
• Use data and key performance indicators to identify opportunities and drive measurable improvement
• Collaborate with Revenue Cycle, Finance, Patient Access, HIM, clinical departments, Informatics, and organizational leadership
• Help develop and improve workflows, policies, technology, and operational processes
• Join a community-focused healthcare organization where your work directly supports our ability to provide high-quality care close to home

Key Responsibilities

Business Office & Revenue Cycle Operations

• 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

Rural Health Clinic & Ambulance Billing

• 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

Accounts Receivable, Denials & Collections

• 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

Financial Assistance & Patient Financial Services

• 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

Leadership & Team Development

• 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

Performance & Process Improvement

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.

Regulatory Compliance

• 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

Fiscal & Strategic Management

• 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

Qualifications

Required Qualifications

Education

• Associate's degree in business, healthcare administration, accounting, finance, or another related field

Experience

• Minimum offive (5) years of healthcare billing and accounts receivable experience
• Minimum ofthree (3) years of supervisory or management experience in healthcare billing and accounts receivable

Knowledge & Skills

• Thorough knowledge of healthcare billing and reimbursement processes
• Strong understanding of Medicare, Medicaid, commercial insurance, and self-pay reimbursement
• Knowledge ofUB-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

Preferred Qualifications

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

What We're Looking For

The ideal candidate:

• 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 workon-site at Pagosa Springs Medical Center on a full-time basis
• Embodies PSMC's WISER values ofWholeness, Integrity, Stewardship, Excellence, and Respect

Schedule & Work Arrangement

This is afull-time, exempt leadership position anticipated to work40+ hours per week.

TheManager: Business Office is an on-site position located at Pagosa Springs Medical Center in Pagosa Springs, Colorado. This position is not eligible for remote or hybrid work.

The Business Office Manager participates in management, Revenue Cycle, performance improvement, utilization review, and other assigned organizational meetings and committees.

Compensation & Benefits

• Compensation Range: $79,456.00 - $99,320.00 annual
• Benefits:Benefits include generous paid time off, separate sick leave, health, dental, vision, life and AD&D insurance, long-term disability and option for short-term disability, and retirement plan with employer contribution.  
• Job Type: Full-time  
• Anticipated End Date for Posting:October 31, 2026. The deadline may close sooner due to an unanticipated business necessity, such as an incumbent vacating the role earlier than anticipated. You are encouraged to apply well in advance of the deadline.  

Pagosa Springs Medical Center is an Equal Opportunity Employer. All qualified applicants will be considered for employment, and we will not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, marital status, or any other characteristic protected by law. Offers of employment are contingent upon successful completion of a pre-employment health and drug screen and background check. 

About Pagosa Springs Medical Center

Pagosa Springs Medical Center is a Critical Access Hospital serving Pagosa Springs and the surrounding southwest Colorado community. Our organization provides hospital, emergency, outpatient, clinic, ambulance, and other essential healthcare services to the residents and visitors of our rural mountain community.

Located in the beautiful San Juan Mountains, Pagosa Springs offers an exceptional quality of life with year-round opportunities for hiking, skiing, fishing, mountain biking, rafting, hunting, and other outdoor recreation.

At PSMC, you'll join a collaborative healthcare team guided by our WISER values:Wholeness, Integrity, Stewardship, Excellence, and Respect, where every team member plays an important role in improving the health of our community.

Apply Today

If you're an experienced healthcare revenue cycle leader who enjoys developing people, improving processes, solving complex billing challenges, and using data to drive results, we'd love to hear from you.

Join Pagosa Springs Medical Center as our Manager: Business Office and help lead the financial operations that support exceptional healthcare for our community.