How medical billing automation can maximize efficiency: 4 strategies for billing companies

Sixty-seven percent of billing professionals still spend more than a quarter of their time on repetitive administrative tasks. This inefficiency isn't just costly — it's preventing billing companies from scaling and maximizing revenue potential.

Medical billing automation offers billing companies the opportunity to optimize operations, reduce errors, and free up staff for higher-value work. This article shares how one company — Medical Claims Billing (MCB) — did just that, along with 4 automation strategies backed by expert insight and real-world results.

Before exploring automation strategies, it's important to understand the challenges facing modern billing companies. According to recent industry data, medical billers face several efficiency roadblocks:

These challenges compound over time, creating bottlenecks that prevent billing companies from taking on new clients or expanding services. Automation can offer a proven path forward.

The foundation of billing automation starts with eliminating labor-intensive workflows that consume valuable staff time. MCB, a New Jersey-based medical billing services provider, struggled with management processes that needed to be updated and revised. 

Owner Bob Trotta recognized the potential benefits of implementing robotic process automation (RPA) to enhance the claims process and automate manual tasks, and turned to Tebra's billing and payments solution for support.

The company processes 25,000 claims monthly. After utilizing Tebra's automated billing solution, the team was able to process 80% of claims without manual intervention and reduce over 10% of time spent by account managers on routine tasks.

Claim submission

Eligibility verification

Status management

Payment posting

To implement RPA, follow these steps:

By automating routine tasks, billing teams can redirect their expertise toward problem-solving, client and payer relationship management, and strategic business development activities that directly impact revenue growth.

"Implementing RPA has significantly improved our operational efficiency, client satisfaction, and financial outcomes,” says Trotta.

Scaling claim processing capacity without needing to add staff is key for billing company profitability. Automation enabled MCB to achieve 50% growth in new client opportunities without adding any new staff.

Here are some ways to optimize billing processes, increase the volume of claims processed, and boost your revenue — with the help of automation.

For any denials you receive, make sure to give them an initial review within 5 business days of receipt. When you want to resubmit claims, ensure all updates align with payer guidelines and timely filing deadlines.

While practices have a deadline to submit appeals, payers must also respond within a set time frame. Leverage automation to track these deadlines and set reminders when a payer’s response is overdue. This allows billers to follow up promptly on any non-responses. 

If a payer consistently misses their response deadlines, it’s important to escalate the issue by reaching out to provider relations to address the breach of contract and work toward a resolution.

While automation like RPA can execute repeatable rules-based tasks, artificial intelligence (AI) can add a deeper layer of intelligence to workflows. It can learn patterns, make predictions, and adapt.

You can use AI to complete tasks such as: 

Alexis Marshall, Client Solutions Manager at Medical Billing Strategies, shares this distinction between automation and AI: “Automation is great for things like posting payments — repetitive, rules-based tasks. But with AI, it can learn fee schedules and reimbursement rates. That’s where it becomes really powerful. In my experience, automated systems don’t catch discrepancies. Where automation is a 1:1 match, AI brings intelligence. It can detect underpayments. Automation can’t do that.”

Most billing companies work with clients using different EHR systems, creating integration challenges that consume staff time and introduce errors. Before partnering with Tebra, none of MCB's clients had integrated EHR and practice management systems. Now, over 70% do, streamlining operations significantly.

You can use an integrated EHR solution or RPA to automate the following processes across different platforms for better efficiency:

This results in accelerated payment from healthcare payers since they receive cleaner, more comprehensive information.

Consider these integration tips to get started:

If you're not ready to get all your clients on a single platform, you can connect external EHRs with Tebra’s billing solution by bringing patient demographic and financial information directly into the Tebra platform.

Tebra provides the basic tools to exchange and accept information from external systems and layers them with established business rules and logic to generate a clean upload of encounters and patient information.

“Tebra's billing solution can provide a flexible and user-friendly solution for medical claims billing, regardless of the various systems and platforms used by our clients," Trotta shares.

Different medical specialties and practice types require customized billing approaches. MCB serves 40 clients of varying sizes and healthcare specialties, having a high concentration of providers in mental health, internal medicine, cardiology, and primary care. 

MCB found that their clients were struggling with financial uncertainty driven by high denial rates. They faced:

To accommodate their diverse client needs, MCB partnered with Tebra to: 

By automating similar labor-intensive tasks, you can concentrate on managing your business and providing dedicated support to practices — so that they can focus on patient care. 

Medical billing automation represents a fundamental shift from reactive, manual processes to proactive, systematic workflows that maximize efficiency and profitability. The strategies outlined in this guide provide a roadmap for billing companies ready to scale their operations through intelligent automation.

The key to success lies in taking a systematic approach. Start with high-impact processes, measure results carefully, and expand automation and AI based on proven outcomes. With the right strategy and tools, medical billing companies can achieve efficiency gains while positioning themselves for long-term growth.

Discover how Tebra provides your billing company with the tools it needs to succeed. Book a free, personalized demo today.