Don’t pick the wrong people to fill business office positions – it is an expensive mistake.

Because staff salaries are the largest component of overhead in any practice, focus on hiring staff who have the skills and talent to do the job. No matter how hard you work, inept business office staff will cost tens of thousands of dollars in revenue leaks. Use the following guidelines to help hire competent winners.

Supervisory staff

If you are hiring a billing or business office manager, this person is responsible for supervising transactions, as well as for hiring, training, and monitoring staff.

Depending on the degree of practice automation, physician cooperation and participation in coding, the number of transactions, and business protocols, the skills and expertise required may vary. Your interview should cover the following important subject areas. Listen for detailed, descriptive answers that outline an articulate business process, including how problems are approached and solved.

Solid written and verbal communication skills: Errors on resumes and poor grammar in cover letters or monosyllabic replies won’t improve once the candidate is hired. Be picky on the first review. Test skills by asking applicants to write an appeal letter for an underpayment by a managed care plan.

Up-to-date knowledge of the industry: Prior experience in “billing” is both a plus and a minus. Someone with 12 years of experience and a “this is the way we’ve always done it” attitude can hurt your operations rather than help it. Ask applicants about modifiers, multiple procedure discounts, and other concepts that competent surgical billers will know the answers to. (With annual changes in CPT, modifiers and Medicare outdated knowledge will be very expensive.)

For a basic Billing Knowledge Assessment Quiz go to http://www.karenzupko.com/resources/forms.html

Well-honed analytic skills: Ask about the reports the applicants relied on in their previous positions. If the only answer is the “aged accounts receivables,” stop. This answer indicates the candidate has no analytic abilities. Listen for a reply that includes aging accounts receivable by payor, by doctor, or by location as well as a detailed review of adjustments, unapplied credits, charge entry time lag reports, and time of service collections. Failure to mention these reports is a predictor of future failure in capturing revenue.

Technology-savvy: Although many practices have invested in Internet connections and better software to run billing, it’s often true that staff doesn’t know how or are unwilling to use technology to improve performance. For example, many staff still do not check eligibility before a patient’s first visit. Batch eligibility makes this easy.

360º view of the revenue cycle: Billing isn’t only a back-end function. If candidates can describe how they worked with the reception or registration staff to reduce front end errors that is a plus. The billing office and front office are attached like you hand to your arm.

Screening candidates

Consider using the tools that most large companies and many practices use to screen out candidates with likely problems. An inability to deal with diverse patient or coworker populations, attendance issues, stealing, a dislike of supervision are some of the tendencies that can be assessed using a variety of Equal Employment Opportunity Commission (EEOC)-compliant tools. Costs for those tools are low – between $25 and $45 and they are well worth the investment, especially when you consider what a bad hire costs you in terms of recruiting and training time. To access the tools KZA uses in candidate selection go to http://www.maximumpotential.com

Never offer someone a job after the first interview; always have a second interview.

Background checks are mandatory. Have all candidates complete a standard application www.karenzupko.com/products/product_trustedemployee.html and sign a release for completion of a background check. Employment applicants should have an attestation statement that says any offer of employment is contingent on the results of the background check.

A background check may reveal that the candidate claims multiple degrees from high school to grad school that were never earned, has an alarming credit history, has employment gaps, or has multiple bankruptcies-not to mention felony convictions.

According to Donna Ploof of Trusted Employees, a company that provides background checks to a wide range of businesses, including medical practices, “One out of every three applicants provides false, inaccurate, misleading, or incomplete information.” Because you trust employees with patient information protected under the Health Insurance Portability and Accountability Act, we well as credit card numbers, you have legal obligation to verify the background of the people you hire, intuition is useful, but do not let it be your only tool in selecting and hiring staff at any level.

Your staff may be your greatest expense, but they should also be your practice’s greatest asset. A terrific team can make your day pleasant and patient’s experiences with the practice memorable; they can develop better systems and contribute to profitability.

Train Staff

In partnership with the American College of Surgeons, American Association of Neurological Surgeons, American Academy of Orthopaedic Surgeons, American Society of Plastic Surgeons and Society for Vascular Surgery. KZA provides detailed specialty specific reimbursement and coding education.