Building RCM Teams in the
Age of Automation

With the increasing adoption of robotic process automation (RPA) and artificial intelligence (AI) in RCM, traditional processes including roles, responsibilities, and workflows are rapidly becoming outdated. Today’s healthcare leaders, many of whom say revenue cycle automation will be widespread within the next five years, are tasked with redefining revenue cycle management (RCM) teams with a focus on oversight, analytics, optimization, and decision support.

“In an age of automated RCM, leaders must integrate emerging technologies while simultaneously cultivating human expertise to oversee exceptions, strategic initiatives, and overall governance,” says Karna Palanivelu, senior vice president of operations at Global Healthcare Resource. “When thinking about how to build an effective team, the key is to ensure people and technology work together collaboratively.”

The following five steps outline key actions to achieve these objectives while pursuing automated revenue cycle management.

1. Rethink roles around technology. As automation shifts the nature of RCM work, retraining and reassigning RCM staff helps organizations avoid redundancies and ensures everyone remains focused on judgment-based tasks that require human insights.

How to do it: The first step is to conduct a role and workflow audit. Understand who’s doing what, where manual work still exists, and which roles are ready for automated RCM support or redesign. For example, some organizations may decide to create a new role for automation analysts who can work with IT and operations to implement and maintain bots. The same is true for organizations that decide to create a new role for AI oversight analysts who can monitor AI tools for errors and work with IT staff to correct them. Similarly, denial management experts can handle exceptions that automation can’t resolve. Or patient financial experience managers can promote consumer-centric engagement, price transparency, and patient financing programs. When thinking about how to build an effective team during a time of automated revenue cycle management, each of these roles (and others) are important.

2. Focus on change management. Automated RCM can trigger anxiety about job loss or role changes and change management addresses staff resistance and fear. It also ensures process alignment, promotes user adoption, and reduces operational disruptions which are all critical components to building an effective team.

How to do it: Communicate clearly and early to explain how automated RCM complements jobs rather than replaces them. In addition to developing a clear vision for automated revenue cycle management, involve staff in technology selection and workflow redesign, and empower champions to provide ongoing peer support.

3. Upskill your staff. With automated RCM comes the need for human oversight. With revenue on the line, RCM staff must be able to detect when automation has failed or needs refinement. Upskilling also helps increase job satisfaction and retention and improve data quality and decision-making.

How to do it: Invest now in training which includes training staff on how to interpret AI output, use AI tools, and improve analytical and critical thinking skills.

4. Insist on continuous improvement. In an age of automated RCM, the most successful teams embrace process improvement, feedback loops, and evolution. This holds true particularly as payers change rules, technologies evolve, and patient expectations shift.

How to do it: Over time, ensure you hire and retain the right people. Investing in those with a growth mindset and who contribute to a culture of continuous improvement will help you evolve steadily. Consider the following RCM team lead interview questions to assess whether leaders have the right mindset to evolve with automated revenue cycle management:

• How do you handle failure? What is a recent example of something you learned because of failure?

• What is one skill you didn’t have but needed to learn quickly. How did you learn it?

• What is a recent example of critical feedback someone gave to you? How did you respond?

5. Partner strategically.When healthcare staffing shortages and/or an inability to access the right talent make it difficult to oversee AI tools in RCM, external partnerships may be necessary. Strategic partnerships are critical because they ensure alignment, transparency, and performance accountability.

How to do it: When outsourcing your revenue cycle, select vendors who embrace automated revenue cycle management, share performance metrics, and promote collaborative governance models. Asking the right questions helps organizations find the right fit.

Looking ahead
As healthcare organizations continue to leverage automated RCM, teams will undoubtedly become smaller and more tech-savvy with reimagined roles centered on cross-functional collaboration. The result? Fewer denials, faster cashflow, higher staff productivity, improved patient satisfaction, and stronger audit readiness.

“RCM teams of the future will look fundamentally different; however, with automated revenue cycle management, they will be stronger, more efficient, and more effective than ever before,” says Palanivelu.