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Registrars and Billers Top the Most In-Demand Rev Cycle Positions

Analysis  |  By Amanda Norris  
   March 23, 2022

Revenue cycle leaders scramble to fill roles in various stages of the revenue cycle process.

Healthcare leaders ranked the roles within the revenue cycle where they most need talent in a new survey released by AKASA.

The survey, which includes the responses from 400 healthcare financial leaders, ranked registrars, billing specialists, and patient follow-up staff as the most in-demand positions within the revenue cycle.

These revenue cycle roles followed closely behind:

  • Front-office staff
  • Central scheduling
  • Denial specialists
  • Authorization staff
  • Claims specialists
  • Collections

"We're seeing staffing gaps at every stage of the revenue cycle process," Amy Raymond, vice president of revenue cycle operations at AKASA, said in a press release.

"Revenue cycle departments are essential to the success of a healthcare organization," Raymond said. "When there's a demand, revenue cycle specialists are hired. When there's less demand, they're let go. This reactionary hiring cycle results in permanent workers often facing too much work and patients having a less-than-stellar financial experience."

The healthcare field has lost an estimated 20% of its workforce over the past two years , and hiring for those large staffing gaps has proven difficult for revenue cycle leaders.

Carlos Bohorquez, CFO at El Camino Health in Mountain View, California, told HealthLeaders that there was already a staffing shortage at his organization before the pandemic, and that forces each worker to put in a bit more effort.

But when the pandemic hit, and many healthcare workers were forced to do double shifts or work without days off, some quickly reevaluated their commitment to the profession. Then, as staff started quitting, things got especially bad.

Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, is well aware of the need for registrars within in the revenue cycle and has worked diligently to improve staff retention.

"We developed a tiered pay scale. People who check in patients are paid in tier one. Once you have training and you've been in the department for a while, you can move into pre-registration, and you would get a bump in your pay. You're growing; we trust you with more and more responsibility. Tier three would be the authorization team and financial counseling," Auman told HealthLeaders.

"Since we implemented all of this, the staff satisfaction and our retention has gone up. Turnover was reduced by 42% to 25% in two years.

"These people need to know how to do this job. It's not just checking in patients; it's not just creating an encounter. There's important information that you need to get up front. We have changed that mindset in doing a career ladder.

"It was awesome because I wanted to show people that you can come in to access. Don't think of it as an entry-level position; think of it as an opportunity to build your skill set … you can go on to do something different in the revenue cycle. … It opens their eyes [that] there's a career path within healthcare that's not clinical."


Amanda Norris is the Director of Content for HealthLeaders.

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