The Revenue Cycle Workforce Crisis: How Leaders Are Fighting Back

The healthcare workforce is in crisis, and revenue cycle leaders are feeling the pain too.

Across hospitals and health systems, staffing shortages, high turnover rates, and an increasingly fickle workforce are making it harder than ever to maintain financial stability.

The revenue cycle is the backbone of a hospital’s financial health—if billing, coding, and patient access teams aren’t fully staffed and engaged, the entire operation suffers. Leaders are in a fight for talent, and the battle is getting tougher by the day.

This was a huge topic of conversation for more than the two dozen revenue cycle leaders from hospitals and health systems across the country that gathered for this year’s Revenue Cycle Exchange.

Here’s how the revenue cycle leaders at this year’s February event in San Antionio, Texas, are striving to make a difference in their organizations’ workforce.

Why Is It So Hard to Fill Revenue Cycle Jobs?

Hiring in healthcare has always been challenging, but the current environment is unprecedented. Despite aggressive recruitment efforts and increased advertising, revenue cycle leaders are struggling to get qualified candidates through the door. And when they do? Many candidates ghost them before the first day or leave after just a few months, the attendees said.

Is it salary? Is it generational differences? The answers aren’t clear-cut.

While competitive wages are always a factor, today’s workforce also prioritizes flexibility, work-life balance, and remote opportunities.

Revenue cycle leaders at the event said they are now competing not just with local hospitals but with systems across the country that can offer fully remote positions. If a coder in a small town can make the same or more money working for a large hospital system in another state without ever leaving their home, why wouldn’t they take that opportunity?

To combat this, some leaders at the event are considering alternative pay structures, including performance-based benefits and increased incentives for hard-to-fill roles.

Keeping Staff from Walking Out the Door

Hiring is only half the battle—keeping employees engaged is proving just as difficult.

Hospital leaders at the event say they are spending enormous amounts of time and resources on training, only to see staff leave within months. The cycle is exhausting and costly.

One major issue is a lack of commitment, one executive said. Some employees jump at the first better offer, while others disengage due to a lack of appreciation. Employee engagement is no longer a nice-to-have—it’s a survival strategy. Revenue cycle leaders are pushing for more meaningful recognition programs, ensuring staff feel valued beyond just a paycheck.

However, there’s a fine line to walk.

Leaders stressed that while it’s important to communicate appreciation, discussing bonuses openly can backfire. Expectations can spiral out of control, and if employees feel entitled to rewards rather than motivated by them, the entire system collapses.

Instead, transparency about performance metrics and incentives is proving to be a more effective approach.

Pictured: Revenue cycle execs talk shop at the 2025 Revenue Cycle Exchange in San Antonio, TX.

Preparing for the Inevitable

Even the best employees won’t stay forever.

Without a strong succession plan, revenue cycle teams are at risk of collapsing when key leaders move on. The industry is seeing a wave of retirements, and younger professionals aren’t always ready to step up.

Forward-thinking revenue cycle leaders are proactively identifying future managers and equipping them with the skills they need before a leadership vacuum emerges. Training programs, mentorship, and leadership development initiatives are becoming essential tools in preventing chaos when experienced leaders leave.

Another strategy is focusing on hiring candidates with both technical experience and soft skills.

“While technical proficiency can be taught, emotional intelligence, communication, and adaptability are harder to instill,” one leader said.

Hospitals are prioritizing well-rounded candidates who not only understand the numbers but can also lead teams effectively.

The Remote Work Debate: Solution or Setback?

Remote work has changed the game for revenue cycle leaders, they say.

While it offers a solution to staffing shortages by allowing hospitals to hire beyond their immediate geographic area, it also introduces new challenges. Some leaders argue that remote work has made employees less engaged, while others see it as the key to long-term retention.

The reality is that remote work is here to stay, and revenue cycle teams must adapt.

The focus now is on measuring productivity transparently and setting clear expectations for remote employees. Leaders who find ways to balance flexibility with accountability will have the best shot at retaining top talent.

But for hospitals in small markets, the competition is brutal. It’s no longer just about catching “epic talent” in a local area—now they have to compete with national systems that can offer fully remote roles.

The playing field has changed, and leaders are forced to rethink their entire approach to staffing.

Are We Meeting the Needs of a Changing Generation?

A generational shift is shaking up the revenue cycle workforce.

Younger employees are demanding different work environments, often pushing for higher wages, shorter hours, and more flexibility. Some leaders question whether hospitals should meet these demands or push back against what they see as unrealistic expectations.

One thing is certain: the workforce has changed, and hospitals must evolve with it. Some revenue cycle leaders are experimenting with alternative work schedules and flexible hours to accommodate different needs.

The challenge is finding the right balance between meeting employee expectations and maintaining financial stability.

What else?

Well, social media and the internet have also reshaped how employees view work, they say.

Many younger professionals have a skewed perception of salaries and job expectations, leading to difficult negotiations. Revenue cycle leaders must be strategic about compensation—offering competitive packages without getting caught in expensive bidding wars over minor salary differences.

How to fight for a Stronger Revenue Cycle Workforce

The healthcare revenue cycle workforce crisis isn’t going away anytime soon, but top-performing leaders are proving that it can be managed.

By pushing innovative recruitment strategies, prioritizing retention efforts, and rethinking workforce expectations, they are slowly turning the tide.

The fight for talent is fierce, but the solution isn’t just throwing more money at the problem.

True success lies in creating an engaged, motivated workforce that sees the revenue cycle as a career, not just a job. Leaders who embrace change, invest in their teams, and remain flexible in

their approach will be the ones who come out on top. For hospitals and health systems, the time to act is now—because without a strong revenue cycle team, the entire operation is at risk.

The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page. 

To inquire about attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.