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Hiring Top-Quality Revenue Cycle Staff

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Published: 12Oct2008
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The role of patient accounting positions within a hospital has been constantly evolving. In the past, patient accounting and business office personnel would simply hire individuals with little to no training to stuff bills in envelopes and sit-back to watch claims be adjudicated and paid within 21 days. Finding individuals to fill these positions was an easy task because the job descriptions lacked complexity and challenge.

Today, Revenue Cycle Managers are becoming more and more in "dire need" of the expertise needed to improve cash flow and decrease bad debt for their institutions. But a tight labor market combined with ever-increasing complexities of managing healthcare receivable functions has intensified the need for very qualified and talented personnel.

In today's healthcare landscape, revenue cycle personnel need to be knowledgeable in a wide range of areas, including topics such as changing Medicare regulations, compliance laws, billing deadlines, managed care billing dos and don'ts, HIPAA regulations, denial management, among others.

When patient accounting managers need to hire employees, many comment about unimpressive applicants or a shortage of talent. Due to the complexities of healthcare billings and collections combined with the shrinking labor market, hiring the right patient accounting person takes on immense importance.

Hiring within the PFS arena is the foundation for successful revenue cycle management. Not only is it now very difficult to find experienced help, you cannot afford to make a hiring mistake. You cannot afford to make hiring mistakes and you can't build a great department without great people. Studies show that every hiring mistake can cost a facility 1.5 times the candidate's salary.

So, how do you know you are picking the best candidate for the position? Furthermore, how do you know you are conducting an effective search for qualified candidates?

Look at the salary you are offering versus the salary on the applicant's last two jobs. If your offer is less, don't expect longevity. Some workers are "job hoppers" who end up going from one job to another after only a short time. Encourage applicants to apply even when you have no openings. Crisis hiring situations may arise when one or more employees quit without notice. One way to avoid crisis hiring is to continue accepting applications even when you are fully staffed. Conduct an effective job interview. Your interview questions should help you understand what the candidates did at their last job, how they did it, why they did it, how much supervision they had, how they felt about their job, and why they left (if they are currently not employed). Make sure new hires will display plenty of enthusiasm. Do not conclude the interview unless you have gathered enough information to properly evaluate the candidate. Make sure you have a connection with the applicant. Mutual interest is key. Look for someone who is just as interested in you and your organization as you are in them. Someone who asks questions and is interested in learning about the department and organization will most likely be a good candidate. Since references can be the decisive factor on whether one is offered a position, it is important to choose referents carefully. When checking references, ask questions such as:

In your opinion, what are the person's strengths? In what ways could the person improve? How much of a contribution do you think this person made to your company while working there? How would you compare the person's work to others who had the same position? Do not be in a rush to fill a position. When you do hire your new patient accounting representative, conduct thorough training on billing systems, processes, protocols, policy and procedures, etc. No matter how much experience an individual has, he or she has to learn about your department, its software and other related departments. Introduce the new hire to others in the hospital to create a team atmosphere and to help with the education process.

In some cases, a temporary person is brought in when a permanent spot opens as a way to audition a candidate. Astute revenue cycle directors are turning to temps in part because it's easy to meet fluctuations in demand by adding or cutting them. This increasing reliance on temp help during the past decade has grown significantly during the past decade due to the ability to obtain qualified candidates in a short amount of time.

Whether filling a temporary or permanent opening, hiring the best, most qualified revenue cycle professionals is essential to preserve the integrity of your organization and to help improve your bottom line.

Jim Yarsinsky, CPAM is president of Expeditive, an interim revenue cycle staffing firm. Prior to forming Expeditive, Jim was founder and president of Expeditive, a hospital AR turnaround firm. Jim can be reached at 877-PFS-ASSIST or at jyarsinsky@expeditive.com. Please visit http://www.expeditive.com

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