The healthcare industry is facing a critical staffing shortage that is impacting medical billing operations and revenue cycle management. With an aging population and expanded access to healthcare, the demand for healthcare services is rising. However, there is a shortage of healthcare workers, including medical billers and coders, to meet this growing demand. This is forcing healthcare providers to get creative with their medical billing strategies and leverage technology in new ways.
The Medical Billing Staffing Shortage
According to a survey by AMN Healthcare, nearly 9 in 10 healthcare executives reported shortages in medical billers and coders. The Bureau of Labor Statistics predicts employment for medical records and health information technicians will grow by 8% between 2020-2030. However, healthcare providers are struggling to fill these open positions.
The COVID-19 pandemic exacerbated existing staffing challenges for medical billing teams. Burnout and early retirement led to a loss of existing staff. Hiring and training new staff has been difficult with ongoing labor shortages across industries. Remote work opportunities are also making recruiting and retention more challenging for on-site medical billing positions.
Short-staffed medical billing teams are unable to keep up with the volume of claims and paperwork. This backlog leads to claim denials and delays in payments that negatively impact the organization’s bottom line. Without adequate staffing, medical billing teams can’t optimize revenue cycle performance and ensure the practice or hospital is appropriately reimbursed for services.
Transition to Outsourced and Automated Billing
To adapt to smaller in-house teams, many healthcare providers are shifting more medical billing responsibilities to external partners. Outsourced medical billing services provide trained specialists who can maximize claims reimbursement without adding to internal headcount.
According to a Black Book survey, 96% of hospital leaders report using outsourced revenue cycle management services. Offsite medical billing teams act as an extension of the in-house staff. They take on labor-intensive billing tasks, claims follow up, and denial management, freeing up the internal team for higher-value responsibilities.
Many medical billing service partners are also expanding their use of automation to increase efficiency. Robotic process automation can help streamline tedious billing tasks like data entry and report generation. AI-powered systems can auto-code claims, identify billing errors, and reduce time spent on denial management.
Adopting New Technology
Healthcare providers are also adopting new technologies to optimize in-house medical billing operations with limited staffing. Transitioning from manual to automated systems not only reduces administrative workload, but also minimizes costly claim errors and improves data access.
Medical coding software with natural language processing can scan medical charts and automatically apply the appropriate diagnostic and procedure codes. Cloud-based practice management systems centralize patient scheduling, charting, billing and reporting while allowing staff remote access. Analytics dashboards provide real-time visibility into revenue cycle KPIs to proactively address issues before claim denials occur.
Tablet solutions allow medical billers to work remotely and manage tasks like charge capture and code auditing on the go. Telehealth platforms are being leveraged for virtual billing staff training and online meetings to reduce the back-and-forth of an on-site team.
Revamping Staff Duties and Responsibilities
With more processes becoming automated, billing managers can shift their staff’s focus to more strategic priorities and initiatives. Smaller teams take on expanded responsibilities that maximize their skill sets.
For example, lower-level claims processors may handle basic rejects and denials. Billing specialists focus on resolving and appealing denied claims that require deeper analysis or payer negotiations. Accounts receivable roles expand to include demographic data analysis, identifying coverage issues, and patient financial counseling.
Cross-training and upskilling existing staff also helps fill open roles temporarily. Staff with coding skills could support clinical documentation improvement initiatives in their down time. Expanding employee capabilities through internal training or externship programs is an important retention strategy, giving workers room for growth.
Re-evaluating Costs and Prices
To account for rising administrative costs, some healthcare providers are reassessing their fee schedules and the portion of overhead allocated to billing. Accurately calculating the true costs involved in billing and collections helps set appropriate service fees to cover expenses. Cost-to-collect metrics also help identify where billing costs are excessive compared to the revenue collected.
On the patient side, expanded price transparency regulations are creating an opportunity for providers to engage patients on billing early. More are implementing pre-service cost estimators so patients can discuss payment concerns before receiving care. This allows billing staff to proactively resolve pricing issues and obtain pre-approvals instead of fighting claim denials after the fact.
Adopting New Staffing Models
The traditional Monday-Friday, 9-5 staffing model for medical billing teams does not always make sense with rising after-hours and weekend care options. Innovative healthcare organizations are taking cues from retail, implementing stretched staffing schedules to provide coverage outside core hours.
For example, a provider could assign one biller to handle daytime submissions from an urgent care clinic. Another biller processes claims from the ER department in the evening. Splitting shifts this way optimizes resources while ensuring claims get billed accurately and quickly after care.
Centralized remote medical billing centers are another emerging model. Multiple providers share a dedicated offsite billing team reachable 24/7 instead of each having their own in-house staff. This helps smaller practices cost-effectively scale operations and access top talent. According to a Becker’s Hospital Review report, 92% of rural hospitals are considering or have already moved billing services to an offsite center.
Focusing on Patient Financial Engagement
Progressive billing leaders realize technology can only take them so far with staffing shortages. To further optimize the revenue cycle, providers need to engage patients as partners in the billing process.
Giving patients pricing transparency and financial responsibility education early on sets proper expectations. Automated payment plan tools allow patients to setup affordable installments and save billing staff time on collections. Online patient portals make it easy for individuals to review balances, submit payments, and communicate about bills digitally on their own time.
High-touch outsourced partners provide personal financial advocacy services patients crave but overburdened internal teams cannot reasonably provide. Using compassionate, knowledgeable experts for patient collections improves satisfaction while bringing in more dollars.
Rethinking Workplace Culture and Perks
Of course, offering competitive compensation and benefits is foundational to attracting and retaining billing staff. But in this labor-constrained market, culture and perks have become equally important. Employees are looking for flexibility, career development, and a sense of purpose.
Remote and hybrid work options give employees more flexibility in their schedules and location. Tuition reimbursement programs support continuing billing education and career advancement. Student loan repayment assistance is another valuable benefit for medical billers.
Managers should check in often with remote staff to foster connection and engagement. Something as simple as sending thank you e-cards or scheduling monthly virtual team lunches shows appreciation. Providing opportunities for billing staff to give input makes them feel valued in shaping the department’s future.
Strategic Planning for Future Flux
While many of these shifts have been reactionary due to COVID-19 and “The Great Resignation,” building long-term resilience requires more strategic workforce planning. Annual strategy retreats help billing managers get ahead of future staffing and technology needs.
Forecasting growth, upcoming regulatory changes, and investments needed 3-5 years out allows for smoother proactive transitions. Partnering with HR on long-term recruiting and retention programs ensures the billing department has programs in place to attract and develop talent.
Progress Monitoring and Assessment
As new medical billing staffing and technology strategies are rolled out, managers will need to closely track performance metrics. KPIs like days in AR, denied claims, cash flow, and collection rates indicate if changes are having the desired impact. Staff productivity and turnover are also critical to monitor.
Watching for process breakdowns, claim errors and policy violations after shifts lets managers quickly address problem areas with additional training or support. Patient satisfaction surveys and net promoter scores provide insight into how billing experiences are impacting perceptions of the organization.
Frequent check-ins with internal and external billing team members surface pain points early before frustration boils over. Keeping up with industry benchmarking data ensures metrics remain competitive despite staffing challenges.
Continuous improvement frameworks like Lean Six Sigma help managers control costs and maximize existing resources. Small tests of change identify the most impactful enhancements to scale across the organization. By constantly optimizing operations, providers remain resilient through the ongoing turbulence.
Preparing the Medical Billing Team for Success
Medical billing managers have a lot on their plate ensuring their teams stay productive and accurate with limited staffing. But this period of flux presents opportunities to shape stronger operations if billing leaders provide the right support. Here are some best practices for preparing medical billing staff to succeed through healthcare’s current changes:
Update Training Programs
With new billing technologies and regulations, training cannot be a one-time event. Provide ongoing education so billers stay up-to-date on the latest standards and protocols. Include training on soft skills like customer service and communication to improve interactions with patients.
Bring in external experts on niche topics like appeals processes and payer policies for each major insurer. Invest in paid training tools staff can access on their own time to self-educate. Tap high performers to be peer trainers and share their expertise with teammates.
Listen to Staff Insights
Billing staff work directly with the technology and claims every day. Their insights are invaluable for identifying issues and opportunities. Provide forums for them to provide regular feedback through surveys, meetings, or online forums.
Follow up on concerns raised to show their input drives real change. Communication and transparency fosters trust between staff and leadership. Employees feel invested in improving processes when they help shape them.
Share Department Goals
Make sure the entire medical billing staff understands the department’s key objectives and metrics. This context helps them see how their individual role ladders up to impact organizational success. Recognize their contributions toward shared goals during team meetings.
Provide clear expectations for what billing quality and productivity looks like based on their position. Offer incentives connected to department goals like small bonuses for hitting revenue cycle targets. Aligning rewards to results boosts motivation.
Promote Work-Life Balance
Billing roles can be high-stress and fast-paced. Make sure staff take breaks, use vacation time, and avoid excessive overtime. Be flexible on schedules when possible to accommodate childcare needs or doctor appointments.
Small perks like bringing in lunch or closing early before a holiday weekend shows you value work-life balance. Checking in on a staff’s well-being and adjusting workloads if someone seems overwhelmed demonstrates care.
Cultivate Community
Remote staff especially need a sense of connection. Organize video coffee chats so teammates can socialize informally. Conduct virtual icebreakers or scavenger hunts before meetings to have fun together. Send cards to celebrate birthdays, work anniversaries, and holidays.
Create opportunities for remote and on-site staff to bond and build camaraderie. If local, organize an occasional in-person happy hour or staff picnic. Order Grubhub or gift cards so remote staff can join the socializing virtually.
Celebrate Successes
Recognize staff who go above and beyond by calling out their contributions in team meetings or internal newsletters. Send praise directly to their manager highlighting the positive impact of their work.
Use small monetary rewards or gift cards to recognize major accomplishments. For example, award a top performer each month or quarter with a bonus or gift certificate. Praise and perks for a job well done boosts morale.
By supporting their medical billing staff with training, communication, flexibility, and appreciation, healthcare providers equip them to take on new challenges successfully. Even with limited resources, managers can build an engaged, high-performing billing department. While the industry faces much uncertainty ahead, investing in staff demonstrates the organization values their skills and abilities to drive better revenue cycle performance.
The Road Ahead
While staffing shortages show no signs of slowing, they are unlikely to cripple medical billing long-term. Challenges are encouraging overdue improvements that engage patients as partners in the revenue cycle while aligning billing operations for efficiency. Healthcare administrators who embrace change and stay focused on employee needs will thrive in the new healthcare landscape.
With careful planning and a patient-centric mindset, providers can set their medical billing teams up for success despite resource constraints. As medical billing continues adapting to market conditions, technology and talent strategies will play key roles in maximizing revenues. Healthcare finance leaders ready to experiment and reinvent century-old practices will shape the future of their organizations and the entire revenue cycle management field.
