Some tips on hiring billing staff

Physicians and managers dread the day an employee says she will be leaving the practice.  There are just so many challenges to think about: How long will it take to find a replacement, can I find a competent person,  how much training is required and does anyone really have time to dedicate to all this? Regardless of the answers to those questions, the pursuit begins immediately.  But the most effective search begins by setting a good foundation for success.

Learn from the departing employee

Find out why Karen is really leaving and promise to maintain confidentiality.  She may tell you it’s a job closer to home or she is making a career change, but those are vague responses.  It is suggested that you tell Karen you value her opinions about the practice and set up a time the following day to meet with her. You may need to probe to get the real reasons, but it is important to learn from this experience.  It may result in finding out she feels too much is expected of her, that a co-worker is slacking and difficult to work with, or that the job responsibilities have shifted and she no longer enjoys it.  The findings may result in an opportunity to intervene and make positive changes to improve the work environment.

Next, review the job description and ask her if it is realistic and, if not, what changes should be made.  This input will help assess how the position might be improved before beginning the search for a new employee.

Finding the right candidate  

Traditional advertising can be effective, but watch the costs; they can kill a budget. Use the costs wisely by writing a concise and purposeful ad that inspires someone to respond. Such descriptive phrases as “it’s a busy practice” or “demanding, fast-paced” are apt to scare off some candidates.  At the same time, words like “attractive,” “challenging,” “opportunities for growth” are all stimulating to people looking for work.

Turn to on-line message boards through various professional organizations, advertising on Craig’s List, Monster and other electronic bulletin boards, and posting openings on your website.  Asking people to e-mail their resume ensures they are professional enough to have an updated resume.  Networking among your peers and through your vendors will help get the word out, as well.

Carefully review each resume to see how closely the applicant’s education and experience match the requirements of the job description and identify problem signs such as a lack of stability in their work history.  Now it’s time to place calls to schedule interviews with the best candidates.  This is an opportunity to screen the person further to determine if he seems like a good match for your needs.  Does he have a professional attitude and appear eager about the opportunity you present?  Is he willing to bend his schedule to accommodate an interview? These are important clues to pick up on. It’s an indication of future behavioral expectations.

The interview plan

The final goal is select the best candidate. The processes to accomplish this are critical to your success, including the interview appointment.  For example, did the applicant:

  • Arrive on time;
  • Wear appropriate attire; and
  • Properly complete the application form?

These are key factors to integrate into the selection process.  After all, if the candidate couldn’t get to the interview on time, there is every reason to believe he will be a tardy employee. If the application form was messy, incomplete or inaccurate, you will be facing those challenges if you hire him.  Don’t compromise on these important facts.

Begin the interview with a short dialogue to make the applicant comfortable, such as, how long have you lived in the community, how far from our office do you live or did you have any difficulty finding the office?  Be sure not to ask questions that invade privacy or that even give the slight hint of possible discrimination.  This includes race, marital status and whether they have children.  Check with your state’s employment discrimination laws.

Then move on to ask open-ended questions to solicit opinions and values, rather than questions that are answered yes or no.  For example:

  • Why did you leave your last position?
  • What did you like most about the job?
  • What is the worst work experience you’ve ever had?

Then ask him to describe his ideal job.

Next, you will want to tell the candidate about the practice culture and mission, and describe the expectations of the position.  Don’t sugar-coat it.  Let her know exactly what you expect and what the position is all about.  Use the job description to help you compare the person’s skill set to your needs, but don’t show it to her at this juncture.  This will ensure she isn’t tempted to match her skill set to the responsibilities on the description.  She may have stated she has three years of insurance experience, but that is a very general statement. Ask pointed questions to better understand her work background – what specific tasks she performed and what outcomes she was responsible for in her past positions.

It’s also a good idea to give an explicit problem-solving question that would be relevant for this position.  For example if she is applying for the insurance department, ask her what are the three most important steps required to improve patient collections or how would she identify a claim that needs to be appealed. Once you have nailed down the specific experience, show her the job description and ask her to tell you the tasks on the description that she most enjoys and what is the one thing she likes the least.

Close the interview.  When wrapping up the interview, ask her to rate this opportunity on a scale of 1 to 10.  Make sure you are provided with a list of professional references that include phone numbers. Then tell her when you expect to make a decision and whether you will contact her at that point.

Now you are armed with the information needed to make an objective decision and determine which candidate is best suited for the position.  This is an arduous process, but it is essential to improve your odds in making the best decision.  In the end there are only two primary hiring mistakes:  Either you picked the wrong person or you didn’t provide the training, tools and environment required for the new hire to succeed!

Sample Interview Questions

Here are some sample interview questions to use in your quest for the right billing team:


1.      How do you see the manager’s responsibility in supporting the billing department?

2.      What benchmarks would you use to rate the billing department’s performance?

3.      What role do physicians have in supporting the billing staff?

4.      How do you avoid embezzlement in the billing department?

5.      What training tools are essential to train a coder when she or he joins your staff?

6.      How important do you think it is for a coder to be certified, and why?

Sample Problem-Solving Question for a Manager:

If revenue is plummeting, compromising cash flow, what would you do to fix it?

Billers and coders:

1.      What role does the practice’s financial policies play in your ability to succeed?

2.      What training is required to be a highly qualified coder, biller?

3.      Tell me what you do on a regular basis to keep your skills honed.

4.      How can physicians help expedite the claims submission timing trends?

5.      What advice would you give someone looking to gain the skills needed for your position?

6.      Can you suggest the three most important benchmarks to rate the billing department’s performance?

Sample Problem-Solving Question for a Biller:

If a physician complains that his revenue is less than his colleagues when he is seeing more patients, how would you go about identifying the reason and coming up with a long-term solution?

Have questions? I’m here to help.