By Tarah Vanhooser, CPC, CSMC, PACS, PESC
Vice President, Ancillary Services
Most health-related articles and conference speakers focus on the growing shortage of clinical professionals to serve an expanding and aging population. But the volume of clinical services performed drive a corresponding shortage of highly trained, skilled and dedicated revenue cycle management (RCM) professionals working in the “back office” to promptly and accurately process claims into timely and optimum payments.
Like their clinical counterparts, the critical RCM component of the business also faces an increasing crisis caused by staffing shortfalls. These shortages not only overload existing employees with additional administrative tasks, but they also squeeze tight provider administrative budgets to fund the latest AI-related technologies that can support RCM activities.
In a Healthcare Financial Management Association (HFMA) study, within the umbrella category of “payer challenges” respondents were asked to name their three highest areas of stress — 52% listed prior authorization, 31% cited workforce shortages, 25% chose the rising cost to collect, and 24% named cybersecurity threats among their chief concerns.
Whether being grappled by in-house or outsourced staff, these issues and the underlying staffing issues have made it much more difficult to attract and retain top-tier employees in an increasingly competitive job market. Plus, new employees, often overwhelmed by the learning curve and decreased job satisfaction, can too often contribute to greater errors in billing and claims processing. And higher staff turnover also leads to information gaps, slower turnaround and often increased wage costs.
In industry studies, the growing shortage of skilled RCM workers is shown to cause, among other negative outcomes:
- Missed opportunities to pursue or follow-up on additional revenue opportunities, such as correcting coding errors, pursuing underpayments, work denials timely, and review key performance indicators (KPI) metrics to drive process-improvement opportunities.
Bottom line…a revolving door for an organization’s revenue cycle staff can cause provider organizations to struggle to meet and improve processes and outcomes across the board.
Competition drives up labor…even in India and elsewhere
Certainly, Advantum Health is strongly committed to having an integrated team in the U.S. India and Mexico, giving recognition to our many staff members working tirelessly in offices across the three countries. But even in areas known for providing a large pool of highly educated and dedicated workers, increasing demand is causing greater competition among healthcare IT companies operating there. That can quickly lead to higher prices. And while the countries do have a large group of IT professionals, the number of those professionals qualified in the unique and ever-evolving healthcare industry is smaller, creating a growing gap between supply and demand.
So what’s the Advantum Health answer?
First, Advantum Health is in an optimal position to deal with quickly changing and growing industry standards. Through a combination of acquisitions, mergers and growth, we’ve been doing it for more than 30 years. We also leverage our proprietary AI system to empower our team members to speed tasks with an extremely high level of accuracy and efficiency. That keeps costs down and results high.
We’re committed to fostering a sense of teamwork, collaboration and — yes, family — between staff across all offices, which contributes to higher retention rates. We mark holidays together, and have various good-natured “challenge events” between departments and locations. It all makes for an important bond, and encourages people to want to stay with Advantum Health as an integral and respected part of our team.
Logic and countless studies such as from the highly respected Gallup organization show that a company’s current employees can be some of the most-powerful brand ambassadors to have a dramatic impact on a company’s potential talent and customers…especially during a time and industry where there is heightened competition. Potential new team members are attracted to — and stay — due not only to those in-house recommendations, but because of the standard enticements of salary and benefits packages. Among other aspects that persons in the workforce cite as extremely important are to:
- Allow me to do what I do best
- Accelerate my professional or career development
The Advantum Academies
At Advantum Health, we’ve been implementing a series of six-week academies for virtually each of our service areas. Bright, enthusiastic interns come on board, most of whom become employees at the end of their academy graduation. Just a few examples are:
- PES (Provider Enrollment) — The first Academy launched Jan. 2, 2024; the fourth one just concluded in mid-January 2025. Out of 61 interns who successfully completed the academies, 47 were offered positions; to date, 87% of them have been retained.
- PA (Prior Authorization) — The first PA Academy began April 15, 2024. We just completed our third academy which finished Dec. 19, 2024. All 44 interns successfully completed the academy and were offered positions. As of this writing, we have an 86% retention rate.
- RCM — As of this writing, the RCM class has transitioned from classroom to live-action training. We’ll provide updates on retention rates as available.
The academies combine a solid foundation of superior RCM processes and a comfort level with our team. They appreciate learning the pathway to success at Advantum Health, and the excitement of gaining knowledge through on-the-job training. We have a graduation ceremony at the conclusion of each academy where graduates’ achievements are celebrated. The responses — and the retention — of our graduates have been overwhelmingly positive.
A great way to learn, become engaged and energized, says academy graduates
“The academies are a great Advantum Health initiative, giving good opportunities to the young and new talents to showcase their skills,” said Singireddy Manish Reddy, junior trainer who participated in the initial PES Academy training class. “The program is well-organized and executed in a way that covers all aspects of provider enrollment, and makes it easy for students to understand the process. Students are trained on live applications and payer calls. As we learn, the company also comes to understand how we are learning Advantum’s processes. ‘Fun’ activities also helped us get acquainted and feel both engaged and energized. The academies are a great way to become integrated with the organization and help each of us reach our next career milestone.”
“Stepping into the academy, I’ll admit I was a bit nervous at first,” admitted Vishvitha Kothuri, an apprentice in Provider Enrollment. “But with the support of an amazing team and a great trainer, I was able to become comfortable and knowledgeable about Advantum Health, its processes and its people. Through the academy, we all felt welcomed as we learned new things and benefitted from real-time feedback. Since joining the team, I’ve had an incredible experience, and I’m eager to contribute to our success.”
Train, embrace and retain
We have found that this combination of training and welcoming potential new team members has led to a strong retention and growth standard for the Advantum Health team. In this period of rapid change and resource competition in the healthcare revenue cycle industry, we continue to do all we can to serve our customers’ needs while building and strengthening our exceptional team members as well.