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RCM Healthcare: The Unexpected Costs of Recruiting Billing Employees

Authored by: Phallynn Espinoza

When reading the news, it doesn’t take long to find stories about the ongoing medical provider shortage. With so many providers retiring the industry is in a bit of a lurch, resulting in longer wait times and concerns over the future. But what isn’t discussed as often is the shortage of billing employees, and the impact it has on medical practices.  


Experian Health surveyed 200 revenue cycle executives to better understand the impact of staffing shortages on reimbursement. It found that 96% of survey respondents report a lack of qualified workers has a “detrimental impact” on revenue channels. What’s more, 80% of respondents report department turnover rates as high as 40%, much higher than the national average of 3.8%.  


Of course, attracting and retaining billing employees is expensive, but many unexpected expenses are flying under the radar and eroding the bottom line.  

RCM healthcare and the hidden costs of recruitment  

The industry standard is typically one full-time biller for every 10,000 claims processed annually. Hitting that number isn’t always easy, and the truth is that many departments are understaffed for long periods. And even if you are proactively recruiting, you face many unexpected revenue cycle management healthcare challenges, including:  

  • Positions staying open too long. As you work to recruit, your existing team often struggles to keep up. A huge backlog of work creates many problems, but a major one is turnover. Turnover creates a vicious cycle of ongoing recruitment and persistent short-staffing.  
  • Difficulty attracting candidates. If you haven’t cleaned your house for many months, the cost of cleaning it is higher. Why? It takes more time and effort. As you recruit new billers, one of the many questions asked is the average number of days in AR. A prospective employee wants to know about the workload and stress. In other words, if your house desperately needs a “deep clean,” consider paying a higher salary to fill the position quickly.  
  • More rejected claims. Overworked billing staff are at risk for increased errors. For example, the Experian Health survey found that 70% of respondents report that being short-staffed exacerbates denial rates. The research also showed that 92% report that new staff members make errors that adversely affect claims processing.  

As you work to combat unexpected recruiting costs, many tools and strategies can help. Some focus on lightening your team’s workload by plugging in additional resources, and others focus on RCM technology. Both help you improve RCM services and management and streamline workflows and retention.  

RCM Healthcare: Breathing life back into struggling revenue cycles  

Covid changed things for many industries but for the billing industry in particular. Many billing teams that worked 100% in person went remote during the pandemic. And many of those employees weren’t thrilled to return to in-person work. Some resigned and took positions with competitors that allowed remote work; others left the industry altogether.   


So, for starters, you have two tools available to fill positions faster and retain your existing billers:  

  1. Pay the maximum salary you can afford.  
  2. Offer more flexible work arrangements, such as remote or hybrid working.  

Beyond these two considerations, a couple more strategies include:  

  • Lighten your existing team’s workload. Tedious, mundane tasks exist in the revenue cycle. You can offload many of these tasks and save the higher-value work for your internal team. For example, posting payments is mind-numbing work, and you can outsource it. Outsourcing also allows you to scale up and down when needed, such as when a provider leaves the practice. That way, you don’t need to reduce head count internally and then struggle to scale up and recruit in the future.  
  • Optimize your RCM technology. On paper, maybe you’re not short-staffed. Perhaps you have five full-time billers and process 50,000 claims annually. Yet, your team is still overwhelmed and constantly behind. In this scenario, outdated technology could be to blame.  

Sluggish, “clicky”, outdated software can slow down the most efficient and talented billers. If you aren’t already using a claims scrubber, consider getting one or work with a third-party partner that uses one. It can help drastically reduce the claims errors that slow down processes, create rework, and impact your RCM healthcare success.  

RCM healthcare: Will staffing shortages persist in 2024?  

The short answer is yes. The long one is that ongoing staffing shortages don’t have to impact your practice as much, if you’re leveraging some of the strategies we covered. Also, you’ll be in a stronger position to recapture lost revenue and grow into the future.


Do you need help solving revenue cycle management healthcare challenges? Let us know – we can help!  

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