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This post is the 4th installment of the Medical Billers' Triple Threat series that explores how billing leaders are navigating AI, compliance, and cybersecurity.
Resilient billing companies aren't just surviving the current landscape of AI adoption, cybersecurity threats, and compliance pressures — they're thriving in it. That kind of resilience doesn't come from chasing every new tool or reacting to the latest industry shift. It comes from building strong operational foundations that absorb stress, adapt to change, and reduce risk.
Read on to learn how top-performing billing operations are making strategic choices that create lasting resilience without requiring bigger budgets or more headcount.
The resilience gap
The reality for many billing companies looks starkly different from this ideal. According to Tebra's 2024 survey of medical billing professionals:
- 67% say their staff spends more than a quarter of their time on repetitive administrative work
- 44% say financial pressure is limiting their ability to invest in new technology
These statistics reveal a troubling pattern: Billing teams are stretched thin on manual tasks while lacking the resources to implement efficiency-improving solutions.
As Aimee Heckman, Director of Revenue Cycle Management at Ash Business Solutions, puts it: "Resilience isn't about more headcount — it's about better systems. If your SOPs only exist in someone's head, your margin is always at risk."
"Resilience isn't about more headcount — it's about better systems."
What resilient billing companies do differently
The most resilient billing operations share common characteristics that set them apart. These traits aren't about having bigger budgets — they're about making strategic choices that compound over time:
- Standard operating procedures (SOPs) for claims, denials, and appeals to ensure consistent quality regardless of which team member handles a task
- Integrated tools that eliminate duplicate work and reduce errors, save time, and provide clearer visibility into operations
- Teams trained to manage systems, not just complete tasks and adapt as technology evolves
- Clear vendor evaluation criteria that demand proof of real-world outcomes, not just marketing promises
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Shifting from task-doers to system-overseers
The transition from manual task completion to system oversight represents one of the most significant operational shifts facing billing companies today.
Jeff Hillam, CEO of Red House Medical Billing, describes the fundamental change: "We've been hiring people to do tasks. We now need people to oversee systems. That's a different skill set entirely."
This shift requires deliberate investment in new capabilities:
- Train staff to monitor, audit, and escalate AI-driven workflows. Team members need to understand how to review automated outputs, identify errors, and know when human intervention is required.
- Assign clear ownership for automation oversight. Loren Dilger, CEO of reCLAIM Billing Solutions, emphasizes: "You wouldn't put an employee on a task without a manager in the loop. Why do we do that with AI?"
- Invest in upskilling around logic trees, data validation, and compliance checkpoints. Understanding how automation works enables teams to troubleshoot issues and maintain quality standards.
Heckman reinforces why this ownership matters: "If no one owns the process — from how PHI is accessed to how appeals are submitted — it's only a matter of time before something slips. Clear documentation isn't just good hygiene. It's what protects you when the system fails."
"We've been hiring people to do tasks. We now need people to oversee systems."
The integration litmus test
Technology should make billing operations more efficient, not more complex. Seamless integration should never require your team to build manual workarounds, monitor sync errors daily, export data into spreadsheets for reporting, or rely on vendor support for every issue.
Alexis Marshall, Client Solutions Manager at Medical Billing Strategies, describes her approach: "When we evaluate a vendor, the first thing I ask is, 'Do you already integrate with our systems — and can you share a case study with another client that uses the same integration? … Integration should make things more efficient, not more manual."
What to look for in your next billing tool
When evaluating new technology, prioritize:
- Native integration with your top EHRs and clearinghouses
- Role-based access controls and audit trails
- Automation that works out of the box (eligibility checks, status updates)
- Transparent roadmap and dedicated support
- Reporting that ties directly to financial outcomes
"Integration should make things more efficient, not more manual."
Building sustainable resilience
The billing companies that will thrive aren't those with the most tools or largest teams. They're the ones that have built operational foundations strong enough to absorb industry changes without constant crisis management.
This resilience comes from 3 interconnected elements: strong systems that integrate seamlessly, documented processes that ensure consistency, and skilled teams trained to oversee automation rather than just complete tasks.
Ready to build a more resilient billing operation?
Download our complete guide to facing the triple threat in medical billing: AI and automation, cybersecurity risks, and increasing regulatory scrutiny. Get expert strategies from industry leaders who are successfully building resilient, efficient billing operations.
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