Hospitals are automating repetitive and rule-based tasks, enabling significant efficiencies in the finance and revenue cycle departments.
The ability to execute on administrative tasks in a few minutes with AI creates incredible value for hospitals and health systems. It also means the traditional roles are changing. What will the finance and revenue cycle teams of the future look like?
“In the next two years, I see our team evolving with a stronger emphasis on analytical skills,” said Heather Welch, senior director for revenue cycle at Firelands Health in Sandusky, Ohio. “As technology and data-driven decision-making become more integral, the ability to interpret complex information, identify trends and make strategic recommendations will be critical.”
Michelle Tutem Greame, assistant vice president for revenue integrity at Falls Church, Va.-based Inova Health System, sees a similar trend with her teams.
“Looking ahead, I envision our teams transitioning into more strategic and analytical roles as automation continues to reshape traditional revenue cycle functions,” she said. “Tasks that are routine and repetitive, such as manual status checks and basic data entry, will increasingly be managed by automation. As these functions become automated our focus will shift toward higher value work that requires critical thinking, clinical insight and cross-departmental collaboration.”
Just like clinicians, finance and revenue cycle professionals will have AI to assist them in working at the top of their abilities. Some may need additional training to fill new roles and others will lean into their specific expertise.
“While some traditional operational roles may fade or shift, analytical expertise will take center stage, driving efficiency, innovation and smarter business decisions,” said Ms. Welch.
Shannon Cameron, COO of revenue cycle at Boston-based Harvard Medical Faculty Physicians, expects revenue cycle teams continuing to embrace automation and analytics as they transition to value-based care models. She said the organization is shifting from a “transactional, labor-heavy approach to a more data-driven, strategic function.”
“Key roles and skills we will focus on include data and analytics proficiency where we’ll increasingly rely on team members who can interpret RCM analytics to drive decision-making, optimize payer performance and identify root causes of denials or underpayments,” said Ms. Cameron. “Technology and automation fluency will also be a large integration into our workflow.”
Health systems are still adding to their revenue cycle teams in certain roles. With robotic process automation, AI and predictive modeling, Ms. Cameron expects to hire more team members to implement and manage the tools. She sees a particular need in claims processing, denial management and prior authorizations.
Inova is also still building the revenue cycle department of the future.
“We will continue to invest in roles like data analysts and revenue integrity specialists who can interpret trends, identify the root causes of denials and proactively guide process improvements,” said Ms. Tutem. “Additionally, we are committed to upskilling our current team members, offering training in digital literacy, analytics and problem-solving to ensure they thrive in this more automated and agile environment.”
The revenue cycle team is also becoming more cross-functional as health systems integrate financial and clinical outcomes. Ms. Cameron said she is prioritizing team members who bridge the gap between departments with backgrounds in informatics, compliance and population health. A focus on the patient’s financial experience is also important.
“With the continued consumerization of healthcare, skills related to patient communication, empathy and personalized financial counseling will grow in importance,” she said.
Ms. Cameron’s vision is building a “more agile, efficient and insight-driven revenue cycle operation” which aligns with the system’s broader mission of value-based care. Overall, the revenue cycle teams are becoming less transactional and focused on high-volume, repetitive tasks and instead elevating into more strategic positions.
“Ultimately, our goal is to have our team members doing less processing and more thinking, allowing them to contribute more meaningfully to our organization’s success,” said Ms. Tutem.
