How Many Revenue Cycle FTES Do You Need?

Jim Matthews RCM & Healthcare Financial Management Consultant
Jim Matthews, Principal, Nearterm Corporation

Revenue cycle staffing patterns and ratios are all over the map among provider organizations. This makes sense when you consider that there are variables like technology, volume, patient type, payor mix, skillset, organization structure, mission and management practices. Hospitals often rely on benchmarks in conjunction with staffing decisions. Benchmarks do very little to recognize these variables in a useful way so they are generally not a universally reliable gauge for staffing decisions. However, there are some cases where all of these variables are homogeneous therefore lending credibility to the use of benchmarks for comparative analysis.

A more scientific approach that is globally applicable requires decision making based on the relationship of labor allocation to work arrival. This approach requires (a) full understanding of volumes in terms of type, arrival timing, processing requirements by type etc. and (b) realistic understanding of labor capability and availability at given times. The goal is to match labor allocation as precisely as possible to work arrival so that volumes are processed in a timely manner and productivity is maximized. The following is a hypothetical illustration of how this concept might be applied in various functional areas around the revenue cycle although the concept is applicable in almost every area.


Patient accounting offices usually operate based on a five day work week.  Labor allocation in billing is the same each of the five days of the week (e.g. 8 to 5 Monday through Friday). However, the hospital is a 24/7 business and there is patient volume every day. When the billing team arrives on Monday, they have 3 days billing volume in their queue. If they can complete 3 days of volume on Monday, productivity is “x”. When they arrive to work Tuesday through Friday, they have only 1 day of volume each day so productivity is “X-2 days volume” and remains at that level through Friday. How is the change in productivity reconciled? Another scenario is that if they do not complete the 3 days volume on Monday, the hospital has a backlog until later in the week, assuming they caught up by the time they leave Friday at 5:00.


Flex staffing pattern to allocate labor to work arrival time:

  1. More hours are scheduled for Mondays, tapering down throughout the week based on work arrival
  2. Schedule weekend labor allocation in billing so that labor allocation better matches work arrival

Practical Guidance

The above is an illustration based on assumptions about volume and staffing patterns. It is intended for conceptual design that can be implemented using an engineering approach. Every hospital has to adapt this design in a way that recognizes their operating environment. It requires comprehensive understanding of volumes. However, we have applied this principal of “labor allocation to work arrival” in many hospitals successfully. It works in patient access, billing, follow-up, and most volume driven areas.

Jim Matthews
Principal, Nearterm Corporation

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Ask the RCM Experts

Posted By: nearterm-admin

Senior Director of Revenue Cycle


JOB ID:  EB-1390398644
Location:  Texas

Are you well versed in all things Revenue Cycle? Do you have what it takes to make a difference in a complex, mission driven, multi-facility hospital systems? Then our client would love an opportunity to talk with you about their Senior Director of Revenue Cycle opening.  This position serves as the leader and expert on all billing and revenue collection operations for their multi-site and multi-state outpatient healthcare services company. The candidate will be responsible for the development, oversight, planning and direction of all facets of the revenue cycle process. Management of coding, billing, collections and centralized billing office/front office practice management as it relates to the overall revenue cycle of their various locations. Must be able to ensure efficient billing processes inclusive of claim submission, claim payment and accounts receivable management is in place. Set goals as well as monitor and manage metrics of the company’s accounts receivable, specifically minimizing average days outstanding and action plans concerning reducing A/R over 120 days, identifying process improvement opportunities and implementing new processes to maximize operational efficiencies and ensure revenue cycle management policy and procedures are up to date. Assist in the due diligence and integration of acquisitions, overseeing billing system conversions and other projects as directed by the Chief Financial Officer.


  • Bachelor’s degree in business or related field from an accredited college or university
  • Proficiency with hospital access, coding, billing, collections, and payment regulations required
  • 5+ years of hospital revenue cycle management experience required
  • Previous director level experience preferred
  • Professional certification through HFMA, NAHAM, AAHAM or related professional organization preferred
  • Verifiable RCM success in a multi-facility setting

APPLY NOW  If you are a highly motivated, proven manager with the experience, skills and knowledge to make a difference for our client……………………

Please send your resume in Word or PDF format to:  Copy and Paste the following job title and EB code and place it in the subject line of your email so we can identify the job: Senior Director of Revenue Cycle (EB-1390398644)

If you have any questions or would like additional information please call 888-646-1330


Posted By: nearterm-admin

The Rise of the Agile Workforce

The Rise of the Agile Workforce

Long gone are the days when people work the same job until retirement. Today, the workforce has transformed, and more and more people are choosing to be “agile” workers — that is, taking on jobs on a project-by-project basis. This rise in the agile workforce means that people have the opportunity to work for a multitude of employers and on a multitude of endeavors in a multitude of settings. The rise of the agile workforce can be attributed to many factors, including the benefits this work structure offers workers — and, also, if you work in the healthcare industry, you may just benefit from burgeoning agile workforce, too.

The Basics of Agile Working

The most basic tenet of agile working is that workers are not traditional full-time employees. Instead, agile workers can be freelancers who work remotely, they can be contracted workers who only work for the duration of a project, or they can be temporary workers who are only staffed for a certain amount of time.

The Agile Workforce by the Numbers

While some companies continue to maintain traditional employees, studies are showing that globally, employers are shifting towards hiring agile workers. A 2016 report by the Freelancer’s Union showed that 35 percent of the total U.S. workforce is made up of freelancers. Further, a recent study by HR consultancy Randstad showed that nearly 11 percent of the global workforce is made up of agile workers. Additionally, 39 percent of workers who are currently full-time employees say that they plan to leave their permanent position and join the agile workforce in the near future. Based on the study, Randstad predicts that 50 percent of the workforce could be agile by 2019.

Reasons Behind the Rise

There are several significant factors that have led to the rise of the agile workforce. First, millennials, who have grown up on the internet and with access to a wide variety of digital communication tools don’t want limitations on their career. Instead, they are drawn to work opportunities that expose them to a wide variety of people, places and fields. The Randstad study also showed that 56 percent of workers felt that they were able to earn better money by working for multiple employers.

How Employers (in General) Can Benefit from the Agile Workforce

It’s clear that workers can benefit from the agile workforce trend — but if you’re an employer, what’s in it for you? First, an agile workforce results in happier employees- and thus, more productive ones. Studies show that 80 percent of employees consider telework a perk from a company, and that 37 percent would take a 10 percent pay cut if they could work from home. Ultimately, hiring an agile workforce can save you money: it reduces brick and mortar costs of having to house and equip full-time employees, and it ensures you only staff people when you need them — and not when the workload is low (or slow).

How Healthcare Organizations Can Benefit from the Agile Workforce

Like other employers, healthcare organizations can greatly benefit from hiring workers on an as-needed basis. The staffing needs of healthcare organizations change regularly, based on a wide variety of factors, including changes in the economy, changes in policy, work volume and more. By not hiring full-time healthcare employees, but by simply finding qualified contract workers when needed, healthcare organizations can take advantage of workers who are excited to work for them — and ensure that they’re not spending excess money to pay people they don’t need (and who aren’t necessarily happy to be there).

If you run a healthcare company and you want to move to an agile workforce, you can rely on Nearterm’s 360˚ RCM Managed Services. We can help you meet your staffing needs by providing you with qualified workers who can fulfill your positions, as-needed.

Learn More about our Medical Coding Services

Learn about our RCM Project Staffing Capabilities

Posted By: nearterm-admin

Healthcare Controller

Healthcare Controller

JOB ID: EB-1745336361
Location: Texas

Do you have what it takes to direct the financial activities of a hospital organization? Are you a hands-on, detail oriented manager? Then we have the job for you! Our client is looking for a dynamic individual for their Controller position. The scope of responsibilities includes supervision and coordination of:

  • Bank reconciliation, capitation payment receipts, closing the monthly and annual accounts, general ledger accounting, reconciliation and budget.
  • Ensure compliance with government reporting requirements, including tax reports and payments.
  • Prepare cost analysis, review rates and reconcile revenues to ensure appropriate income/cash flow.
  • Prepare annual budget and analysis, in addition to the preparation of monthly financial statements.
  • Prepare financial information and reports for management, government and other agencies.
  • Provide the CFO with financial reports according to corporate policy.
  • Select, train and evaluate performance of accounting personnel to ensure quality of services and technical expertise.

Additional Information:

  • Bachelor’s degree with a major in accounting required
  • CPA preferred
  • 5+ years accounting experience, 2+ directly related to the healthcare field
  • 3+ years in a supervisory position
  • Strong oral and written communication skills in English required, additional languages preferred


Please send your resume in Word or PDF format to:
Copy and Paste the following job title and EB code and place it in the subject line of your email so we can identify the job: Controller (EB-1745336361)


Posted By: nearterm-admin