How to Improve Medical Biller Productivity – Ten Best Practices to Check

By Taylor Bynum and Janett Checo | Posted: 07/06/2017

Written by Taylor Bynum, Product Manager – Claims and Billing Solutions, and Janett Checo, Sr. Principle Solutions Expert – Claims and Billing Solutions

Medical billers are the backbone of your health care organization’s revenue cycle. They enter massive amounts of data, keep claims flowing and deal with denials to help accelerate cash flow. You know they’re busy, but are they as productive as they could be? Review this check list of biller best practices and see how many are being implemented in your organization.

1. Establish productivity benchmarks and monitor performance.

Benchmarking is measuring key performance indicators (KPIs) and comparing them with national averages and better performing peers. Your claims management technology solution should provide detailed reporting on clean claim rates, timely filing denials and other indicators of what billers do every day so you can improve work processes and correct problems. 

2. Take advantage of automation.

If your processes require billers to constantly intervene manually, they’re probably not highly productive. Claims management technology can automate menial tasks through custom programming specific to your processes and workflow. For example, nThrive™ can customize bridge routines to automate many hours of biller tasks and fill gaps that other solutions leave to you. nThrive’s biweekly edit updates allow you to make changes more quickly than many other solutions.

3. Use reporting to identify opportunity improvements.

A good claims management solution can retroactively review and report the changes each biller makes on claims. Trends showing the same changes being made over and over could indicate opportunities to improve upstream processes and behaviors. 

4. Leverage claims management technology tools.

Sticky notes all over billers’ computers and workstations are evidence of constant rules and process changes in electronic medical records (EMR) systems. nThrive provides training, features like edit resolution tips and links to information so your billers can quickly find out what to do when they encounter an issue. Tools like these help you onboard new staff, reduce attrition and increase quality and consistency.  

5. Give your billers opportunities to contribute more value

Automating mundane and repeat tasks frees billers’ time so they can concentrate on more complex activities and develop higher-level skills and critical thinking. Being able to review and analyze edits, make decisions and suggest workflow improvements adds value and makes their work more rewarding and productive. 

6. Smooth transitions to new technology.

Change can be difficult for billers moving from manual to electronic processes, or from one technology application to another. Claims management technology should be extremely user-friendly and have a user experience (UI) editor that is smart enough to take your staff to the element on the claim that requires a change so they can be faster and more precise in their work. nThrive’s solution meets the criteria and offers on-demand training and webinars for quicker onboarding.

7. Specialize billers by payor type.

Every payor has their own claims rules and guidelines. “Structuring” enables billers to develop strong skills and knowledge in certain areas, which makes them more productive and valuable to your organization. Since payors vary in complexity, this structure gives them a career path, which leads to higher retention. 

8. Learn from your peers.

All health care organizations face the same claims and billing challenges. Talking to others in the industry is a great way to learn about proven methods and technology to improve biller productivity. Some technology providers, like nThrive, have advisory boards, user consortiums and other groups where health care professionals can share their experiences and ideas. nThrive’s client community portal and advisory committees make it easy to connect to peers in your region. 

9. Work across departments.

Even though revenue cycle management works best when all systems and departments are thoroughly integrated, many health care system billing offices, registration areas, coders and other departments remain in their own silos. An experienced claims management solutions provider has reporting and analysis capabilities to help you uncover hidden root causes of issues and engage departments all along the revenue cycle for a cleaner, more transparent system. 

10. Ask for help.

Increasing biller productivity can help you maximize reimbursements, prevent denials and increase staff satisfaction and value. Contact us here about how to implement these and other biller best practices in your health care organization.